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Last reviewed on: 10/10/2020
Reviewed by: Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Doctors don’t know exactly why costochondritis happens, but they do know that some things can lead to it:- Repeated minor trauma to your chest wall
- Overuse of your arms
- Arthritis. Costochondritis can sometimes be a sign of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, or other conditions that affect your cartilage.
- Tumors. These can move from joints and other parts of your body and settle in your chest.
- Respiratory infections caused by viruses
- Bacterial infections, especially in people who use IV drugs or have had surgery near their upper chest
- Fungal infections (in rare cases)
Costochondritis Symptoms
Chest pain linked to costochondritis usually comes on after exercise, minor trauma, or an upper respiratory infection.
- Sharp pain in the front of your chest, near where your breastbone and ribs meet, typically on the left side. It may spread to your back or belly.
- Pain when you take a deep breath or cough. It gets better when you stop moving or your breathing is quieter.
- Tenderness when you press on your rib joints. If you don’t have this tenderness, you probably don’t have costochondritis.
- If costochondritis happens because of an infection after surgery, you’ll have redness, swelling, or pus discharge at the site of the surgery.
Call your doctor if you have any of the following:
- Trouble breathing
- High fever
- Signs of infection such as redness, pus, and increased swelling at the rib joints
- Continuing or worsening pain despite medication
- Nausea
- Sweating
- Dizziness
Go to a hospital's emergency room if you have a hard time breathing or any of the following. They’re not usually caused by costochondritis:
- High fever that doesn’t get better with fever reducers such as acetaminophen or ibuprofen
- Signs of infection at the tender spot, such as pus, redness, increased pain, and swelling
- Persistent chest pain of any type when you also have nausea, sweating, or pain in your left arm. These may be signs of a heart attack. If you’re not sure what’s causing your chest pain, go to the emergency room.
Costochondritis is a common cause of chest pain in children and adolescents. It accounts for 10% to 30% of all chest pain in children. Annually, doctors see about 650,000 cases of chest pain in people ages 10 to 21. The peak age for the condition is ages 12-14. Kids who often carry heavy book bags over one shoulder can be more likely to develop costochondritis. In adults, costochondritis affects women more than men (70% vs. 30%). There is no specific test for diagnosing costochondritis. To rule out a more serious cause of your chest pain related to your heart or lungs, your doctor will probably start with tests like an echocardiogram (ECG), chest X-rays, and blood test for heart damage, among others. If those tests come back normal, they’ll likely see if you have tenderness in any of your rib joints, usually over the fourth to sixth ribs. If you’ve had sternum (breastbone) surgery or are at risk for heart disease, they may recommend getting a test to see if infection is the cause of your chest pain. Doctors will:Costochondritis Risk Factors
Costochondritis Diagnosis
- Look for signs of infection such as redness, swelling, pus, and drainage at the site of surgery
- Recommend a more sophisticated imaging study of the chest called a gallium scan, which will show an increase in the radioactive material gallium
- Check your white blood cell count to see if it is high, a sign of infection
- Recommend a chest X-ray if pneumonia might be a cause of your chest pain
Home Remedies for Costochondritis These home remedies may provide relief from costochondritis: Medications for Costochondritis Your doctor may suggest the following: Surgery for Costochondritis You may need surgery to remove the sore cartilage if other treatments don’t help. Your doctor can refer you to a surgeon. Because inflammatory costochondritis has no definite cause, there is no good way to prevent it. Noninfectious costochondritis will go away on its own, with or without anti-inflammatory treatment. Most people will recover fully. Infectious costochondritis responds well to IV antibiotics and surgery, but recovery may take a long time.Costochondritis Treatment and Home Remedies
Costochondritis Prevention
Costochondritis Outlook
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