Costochondritis
- PMID: 30422526
- Bookshelf ID: NBK532931
Costochondritis
Excerpt
Costochondritis Overview
Costochondritis, also known as costosternal or anterior chest wall syndrome, is related to inflammation of the cartilage connecting the ribs to the sternum. This benign condition presents with localized chest pain exacerbated by movement or palpation, often mimicking more severe conditions like cardiac issues. Diagnosis relies on clinical assessment, excluding serious causes, with treatment involving conservative measures such as nonsteroidal anti-inflammatory drugs (NSAIDs) and physical therapy. Interprofessional collaboration ensures comprehensive patient care and improved outcomes despite its benign nature.
Chest Wall Anatomy
The chest wall consists of the ribs, costal cartilage, and sternum (see Image. Thoracic Bones and Cartilage). The rib cage protects the thoracic organs while allowing for respiratory movements. Of the 12 rib pairs, the first 7 are true ribs, articulating directly with the sternum via their costal cartilages. The rest are false rib pairs, with pairs 8 to 10 attaching indirectly to the sternum via cartilage connections to the ribs above them. Pairs 11 and 12 are "floating ribs," having no sternal attachment. The sternum (breastbone) is a flat bone situated in the center of the anterior chest wall. This bone consists of the manubrium, body, and xiphoid process.
Costochondral junctions, where the costal cartilages articulate with the sternum, are crucial in costochondritis pathophysiology. These junctions are composed of hyaline cartilage, which is susceptible to inflammation.
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Sections
- Continuing Education Activity
- Introduction
- Etiology
- Epidemiology
- Pathophysiology
- History and Physical
- Evaluation
- Treatment / Management
- Differential Diagnosis
- Prognosis
- Complications
- Deterrence and Patient Education
- Pearls and Other Issues
- Enhancing Healthcare Team Outcomes
- Review Questions
- References
References
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- Disla E, Rhim HR, Reddy A, Karten I, Taranta A. Costochondritis. A prospective analysis in an emergency department setting. Arch Intern Med. 1994 Nov 14;154(21):2466-9. - PubMed
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- Mandrekar S, Venkatesan P, Nagaraja R. Prevalence of musculoskeletal chest pain in the emergency department: a systematic review and meta-analysis. Scand J Pain. 2021 Jul 27;21(3):434-444. - PubMed
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