Costochondritis

Costochondritis, also known as costosternal syndrome or costosternal chondrodynia, occurs at the junction of the breast and rib bone, known as costosternal joint. There is a cartilage at the junction of these bones which becomes irritated and inflamed. The condition can be quite painful depending on the extent of inflammation.

➜ The condition has no definite cause. Viral respiratory infections or repeated minor trauma may cause chest pain due to inflammation. It usually occurs in people who use IV drugs or who have undergone a surgery in their upper chest sometime back.

➜ After the surgery, the cartilage becomes more sensitive and prone to infection because of reduced blood flow. It is also known to occur more often in women and in people above the age of 40.

➜ Also, different types of infectious diseases can lead to this condition.

• Viral: Viral respiratory infections like straining and coughing.
• Bacterial: Bacterial infections in the areas of the chest where a surgery was performed.
• Fungal: Fungal infections are rare but also one of the causes.

➜ The symptoms are pain and tenderness at the junction of the breast bone. Too much movement and deep breathing increases the pain, while it gets reduced when the person is at rest and breathes softly.

➜ The pain gradually becomes severe, starting from the front of the chest and radiating to the back, abdomen, arm, or shoulder. Touching the affected area can be very painful for the patient.

➜ The pain originates from one side of the chest but can affect both the sides at the same time. It usually lasts for one to three weeks. The most common sites of pain are fourth, fifth, and sixth ribs.

➜ There is visible redness, swelling, or pus discharge at the site of surgery. It is relatively a harmless condition that usually gets healed without the use of any treatment.

➜ After assessing the nature of the symptoms, a diagnosis can be made. It is based upon the intensity of pain experienced on gently pressing the affected joints. Diagnosis can also be made based on other causes.

➜ Sometimes, tests like a chest X-ray, an electrocardiogram, or a blood test are done to rule out the possibility of other more serious conditions.

➜ Children and adolescents may also get affected by the condition, with the peak age being 10 to 24 years. Adults complaining about chest pain can also be diagnosed with the condition. In adults, chest pain is often considered a potentially serious sign of a heart problem by most doctors until proven otherwise.

➜ People who have recovered from a car accident, where the driving wheel strikes the chest, can also be diagnosed with the inflammation. It is also prevalent in athletes.

Tietze syndrome is often referred to as costosternal syndrome but there is a difference:
a) Tietze is abrupt and the chest pain radiates to the arms and shoulders, which lasts for several weeks.
b) Tietze syndrome shows swelling at the second and third ribs. The swelling lasts for several months.

➜ The treatment is aimed at reducing the inflammation to control the pain. The basic treatment involves: taking complete rest and avoiding strenuous work, applying heat or ice packs on the affected area, and taking anti-inflammatory and pain relieving medicines.

➜ Anti-inflammatory non-steroidal drugs, like flurbiprofen, mefenamic acid, ketoprofen, and naproxen are recommended by doctors.

➜ Sometimes, if the pain is severe, a steroidal medicine is injected into the patient to reduce the pain and inflammation. Infectious costochondritis is treated with IV antibiotics.

In extreme cases, when the patients fail to respond to all these, a surgery is done to remove the inflamed cartilage. Avoidance of activities that may cause strain or trauma to the rib cage or modifying improper posture at home may serve as preventive measures.

Disclaimer: This story is for informative purposes only and should not be used as a replacement for expert medical advice.