Costochondritis is an inflammation of the junctions where the upper ribs join with the cartilage that holds them to the breastbone, or sternum. The condition causes localized 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, but may happen from increased activity involving the arms. Costochondritis (with unknown cause) 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 evaluate about 650,000 cases of chest pain in young people ages 10 to 21. The peak age for the condition is ages 12-14.
Costochondritis is also considered as a possible diagnosis for adults who have chest pain. Chest pain in adults is considered a potentially serious sign of a heart problem by most doctors until proven otherwise. Chest pain in adults usually leads to a battery of tests to rule out heart attack and heart disease. If those tests are normal and your physical exam is consistent with costochondritis, your doctor will diagnose costochondritis as the cause of your chest pain. It is important, however, for adults with chest pain to be examined and tested for heart disease before being diagnosed with costochondritis. It is often difficult to distinguish between the two without further testing. The condition affects females more than males (70% versus 30%). Costochondritis may also occur as the result of an infection or as a complication of surgery on your sternum.
Costochondritis is an inflammatory process but usually has no definite cause. Repeated minor trauma to the chest wall, overuse of the arms, 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 IV drugs or who have had surgery to their upper chest. After surgery, the cartilage can become more prone to infection, because of reduced blood flow in the region that has been operated on.
Chest pain associated with costochondritis is usually preceded by exercise, minor trauma, or an upper respiratory infection.The pain, which may be dull, 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.
- There can be pain with a deep breath or cough.
- The most common sites of pain are your fourth, fifth, and sixth ribs. This pain increases as you move your trunk 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, a diagnosis of costochondritis is unlikely.
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 surgical repair, but recovery may take a long time.