Costochondritis is a painful inflammation of the costchondrial joint connecting the ribs to the breastbone or sternum.
Unlike a similar condition called Tietze's syndrome, there is no swelling in the joint.
Costochondritis causes localised chest pain that you can reproduce by pushing on the cartilage in the front of your ribcage. Costochondritis is a relatively harmless condition and usually goes away without treatment. The cause is usually unknown.
- Costochondritis (with unknown causes) is a common cause of chest pain in children and young adults.
- Costochondritis is also considered as a possible diagnosis for adults who have chest pain. Most doctors, until proven otherwise, will consider chest pain in adults a potentially serious sign of a heart problem. Chest pain in adults usually leads to a battery of tests to rule out heart disease. If these tests are normal and your physical examination is consistent with costochondritis, your doctor will diagnose costochondritis as the cause of your chest pain. However, it is important for adults with chest pain to be examined and tested for heart disease before being diagnosed with costochondritis. Often it is difficult to distinguish between the two without further testing.
- The condition is more common in young adults.
- Costochondritis may also occur as a result of an infection or as a complication of surgery on your sternum.
Tietze’s syndrome is often referred to as costochondritis, but the two are distinct conditions. Tietze’s syndrome usually comes on abruptly, with chest pain radiating to your arms or shoulder and lasting several weeks. Tietze’s syndrome is accompanied by a localised swelling at the painful area (the junction of the ribs and breastbone). In costochondritis there is no swelling.
Costochondritis is an inflammatory process but usually has no definite cause. Repeated minor trauma to the chest wall or viral respiratory infections can commonly cause chest pain due to costochondritis. Occasionally, costochondritis as a result of bacterial infections can occur in people who use intravenous medications or who have had surgery to their upper chest. After surgery, the cartilage in the region that has been operated on can become more prone to infection because of reduced blood flow.
Different types of infectious diseases can cause costochondritis:
- Viral: occurs with viral respiratory infections because of the inflammation of costochondral junctions from the viral infection itself, or from straining from coughing.
- Fungal: a rare cause.
Chest pain associated with costochondritis is usually preceded by exercise, minor trauma, or an upper respiratory infection.
- The pain usually will be sharp and located on your front chest wall. It may radiate to your back or abdomen and is more common on your left side.
- The most common sites of pain are your fourth, fifth and sixth ribs. This pain increases as you move the trunk of your body or take deep breaths. Conversely, it decreases as your movement stops or with quiet breathing.
- The reproducible tenderness you feel when you press on the rib joints (costochondral junctions) is a constant feature of costochondritis. Without this tenderness, you are not likely to be diagnosed with costochondritis.
- Tietze syndrome, on the other hand, exhibits swellings at the rib-cartilage junction. Costochondritis has no noticeable swelling. Neither condition involves pus or abscess formation.
- Tietze syndrome usually affects the junctions at the second and third ribs. The swelling may last for several months. The syndrome can develop as a complication of surgery on your sternum months to years after the operation.
- When costochondritis occurs as a result of infection after surgery, you may see redness, swelling or pus discharge at the site of the surgery.