What is costochondritis?
Costochondritis is a common form of inflammation of the cartilage where ribs attach to the breastbone, the sternum. The inflammation can involve multiple cartilage areas on both sides of the sternum but usually is on one side only.
The cause(s) of costochondritis is not known and may involve several factors. Possible causes include heredity (genetic predisposition), viruses, and trauma (injury).
Costochondritis can be an independent condition by itself or sometimes be a feature of a more widespread disorder. Examples of illnesses that can feature costochondritis include fibromyalgia, psoriatic arthritis, ankylosing spondylitis reactive arthritis, and inflammatory bowel diseases.
What is the Tietze syndrome?
Costochondritis should be distinguished from Tietze syndrome, a condition involving the same area of the front of the chest. Costochondritis is not associated with swelling, as opposed to Tietze syndrome where swelling is characteristic. Tietze syndrome is an inflammation of the costochondral cartilages of the upper front of the chest.
What are the symptoms of both conditions?
One of the main symptoms of costochondritis and Tietze’s syndrome is a sharp pain where your ribs join your breastbone. The pain may come on slowly, or suddenly, and it is usually also felt in your second and third ribs on one side of your body. If you have Tietze’s syndrome, your ribs may feel tender to the touch, and you may also have swelling around the affected area. Sudden movements of your ribs, such as when you cough or sneeze, may make the pain worse.
The syndrome usually affects the upper ribs, especially the second or third ribs. The pain is aggravated by physical activity, movement, coughing or sneezing. Although the pain usually disappears spontaneously, the swelling may persist long after the tenderness has disappeared in cases of Tietze’s.
What cause this disease?
The cause of costochondritis or Tietze’s syndrome is not fully understood, although it may be linked to upper respiratory tract infections, such as sinusitis and laryngitis.
Who can get this condition?
Anyone can develop costochondritis/Tietze’s syndrome, although it is most common among people who are between 20-40 years of age. The condition affects twice as many men as women.
What is the treatment for costochondritis?
- Costochondritis can be aggravated by any activity that involves stressing the structures of the front of the chest cage. It is generally best to minimize these activities until the inflammation of the rib and cartilage areas has subsided.
- Reassurance once the diagnosis is confirmed.
- Non-steroidal anti-inflammatory drugs.
- Local injection of long-acting corticosteroids may help.
- Intercostal nerve block may also help but is rarely required.
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