What is Costochondritis?
Costochondritis is a general type of inflammation of the gristle ribs connected to the breastbone. The inflammation may cover many cartilage locations on both sides of the breastbone but generally is on one side only.
Costochondritis can be a general reason of chest pain in adolescents and children. The condition is referred to as an inflammation in one or more of the costochondral cartilages that generates localized tenderness and pain of the interior chest wall.
Causes of Costochondritis
Typically most of the costochondritis cases are ideally idiopathic. A few cases may be the outcome of costochondral irritation which can be developed because of the following reasons:
- Direct trauma
- Excessive exercise leading to a strain
- Upper respiratory tract infection along with cough
- Different kinds of infectious ailments can also result in costochondritis
- Costochondritis normally develops with viral respiratory infections
- Costochondritis may also unearth after surgery and can be caused by bacterial infections.
- Fungal infections are generally not the cause of costochondritis
- Costochondritis can also come in light with certain types of arthritis, like psoriatic arthritis and ankylosing spondylitis.
Costochondritis symptoms may occur under following conditions:
- Chest pain linked with costochondritis can be caused because of excessive exercise, infection in upper respiratory system or slight trauma.
- The pain generally will be acute and located on the wall of your front chest. It may travel to the back or abdomen also.
- The most common areas of pain are the fourth, fifth, and sixth ribs. This pain augments as you move your upper body or take long and deep breaths. Conversely, it simmers down as your activity stops or with quiet breathing.
- The reproducible softness you feel when you squeeze the rib joints (costochondral junctions) is a symptom of costochondritis. Tenderness is the major symptom of costochondritis.
- Costochondritis is not generally detected by laboratory or imaging tests.
- Personal history and physical examination are the ways of diagnosis.
- Tests are generally done to rule out other conditions that can have identical symptoms but are more severe, like heart disease.
- The doctor may look for reproducible tenderness on the affected ribs. There is generally no significant swelling.
- Blood test and a chest X-ray are basically not of any assistance in diagnosing costochondritis, but these may be considered to ward off other reasons of chest pain.
- However, after sternum surgery, or for people with heart disease history, doctors will ask to conduct more tests.
- They will examine for symptoms of infection like redness, pus, and swelling at the location of surgery.
- A more delicate imaging examination of the chest, a gallium scan, is done to check for infection. It will show enhanced uptake of the radioactive component gallium in the location of infection.
- In cases of expected infection, the white blood cell count may be increased.
- Chest X-ray must be taken if pneumonia is a potential cause of chest pain.
- ECG and other examinations will be conducted if a heart trouble is being detected.
Costochondritis can deteriorate by any activity involving stress. It is usually best to cut down these activities till the inflammation of the rib and cartilage location has subsided.
You must take rest, anti-inflammatory medications, physical therapy, or sometime even cortisone injections. Ice packs are also applied to local swelling which can sometimes assist to reduce inflammation and pain. Local lidocaine analgesic patch (Lidoderm) application can also cut down pain.
Surgical removal of the painful cartilage can seldom be needed if the patient is not responding to any other medical therapy.
Infectious costochondritis needs close tracking to prevent recurrence or spread of the infection.
As inflammatory costochondritis does not display any real cause, there is no virtual way to prevent it.
- It must be assured that the chest pain is associated with neither malignant nor cardiac in origin.
- Treatment may include traditional local care with reasonable use of non-steroidal anti-inflammatory drugs (NSAIDs).
- Cough suppressants can also prove to be beneficial if cough is increasing day by day.
- Stretching exercises are also useful under these circumstances.
- Liberal use of ice is suggested with 20-minute intervals.
- Advise ample rest for the patient's upper extremities and avoid possible precipitating or rigorous activities.
Frequent refractory cases may need consultation with the following specialists:
- Primary care sports medicine physician
It is not impossible or even difficult to live with costochondritis; the only thing that needs to be taken care of is the preventive measures and respect to the guidelines of the physicians prescribed to you.