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Costochondritis

CostochondritisAlso know as costosternal chondrodynia, costosternal syndrome or chest wall pain, costochondritis refers to the acute pain and in some cases inflammation of the costal cartilage which is the structure at the costosternal joint connecting the sternum and the rib. This condition is often associated with chest pain. In most cases, costochondritis is self limiting and will resolve on its own, but there are cases where the condition is recurring and will appear to have little or no sings of onset.

The treatment options available for his condition are limited and the available ones will include a combination of analgesics or anti-inflammatory medication and rest. Cortisone injections may be used in managing cases with intractable discomfort while severe conditions may be treated using surgery.  Patients suffering from costochondritis are advised to stay away from strenuous activities that might cause a pain attack.

The symptoms of costochondritis are in some way similar to the chest pain that accompanies a heart attack. The unexplained acute chest pains should be treated as life-threatening until cardiac relate issues are eliminated as the cause. There are severe cases of the costal cartilage inflammation that is accompanied by swelling and is referred to as Tietze’s syndrome, a term that is often used to refer to the costochondritis condition. There are some medical experts who have pointed to the lack of swelling of the costal cartilage in costochondritis as the factor separating the two conditions.

Signs and Symptoms of Costochondritis

The most common symptoms include pain and in some cases tenderness to palpation which occurs in sternum sides, affect ribs, and is worsened by physical activity, deep breathing, or coughing. During a physical exam the physician inspects and palpates the patient for areas of tenderness, or swelling which reproduce the pain associated with this condition. The location of the sternum pain is the factor that differentiates costochondritis from Tietze’s syndrome. In contrast to Tietze’s syndrome which affects the 2nd and 3rd costosternal joint, costochondritis usually affects the 3rd, 4th and 5th costosternal joints.

Causes of Costochondritis

Costochondritis is not identified in most cases. However, this condition might be as a result of trauma (due to issues such as strenuous lifting, severe coughing, severe bouts, and direct injury) associated with ankylosing spondylitis, tumor, osteoarthritis, scoliosis, and rheumatoid arthritis. In rare cases, the costochondritis might be caused by an infection of the costosternal joint. A large number of costochondritis caused by infections are caused by staphylococcus aureus, actinomyces, salmonella and candida albicans. In some rare cases Escherichia coli can cause costochondritis.

Pathogenesis

The development of costochondritis has remained unclear for medical science. The proposed mechanisms of the injury include muscular imbalance, mechanical dysfunction at the costotransverse joint of the rib, neurogenic inflammation, or costochondral junction mechanical structure derangement.

Differential Diagnosis

There are other chest pain causes that will have symptoms similar to those caused by costochondritis. These include cardiac issues (such as heart attack, aortic aneurysm, myocarditis/pericarditis), gastrointestinal problems (gastritis, gastresophogeal reflux disease, esophagitis), Musculoskeletal (rib fracture, ankylosing spondylitis, bone metastasis from prostrate, breast, plasmacytoma, and sarcomas cancer, fibromyalgia and reactive arthritis), psychogenic ( itemtype=”http://schema.org/MedicalCondition”>panic disorder, hyperventilation, and anxiety), respiratory( pnemothorax, pleuritis, pulmonary embolism and pneumonia). Others include drug abuse, multiple myeloma, and herpes zoster.

Costochondritis Prevention

Because of the fact that costochondritis has no definite cause, there are no known methods in medical science that can be stated as being preventive.

Diagnosis

Costochondritis is diagnosed through the patient’s history and physical exams as opposed to an imaging or laboratory test. The tests might be used when ruling other conditions with similar symptoms out.  This is because some of these symptoms are caused by dangerous conditions such as heart disease.  Blood tests and x-rays will not be useful in the diagnostic process for costochondritis but can be used ruling out other dangerous conditions. The medical practitioners will carry out the test to ensure that the chest pain is not caused by other conditions.

Medical practitioners will be looking for infection signs such as swelling, redness, drainage in case of surgery and pus. There is a complex imaging procedure referred to as gallium scan which can be employed to check for infection. In case there is an infection in the affected area, there will be an increased uptake of gallium which is a radioactive material. An elevation of the white blood cell count in the body can also be used to positively confirm that there is an infection. When pneumonia is suspected, X-rays might be used in confirming if it is the cause of the chest pain. If there are considerations of a heart problem, different tests such as ECG might be done.

Treatment of Costochondritis

Costochondritis treatment typically involves conservative methods such as the application of ice or heat in the affected area as a measure to relieve the symptoms. Patients are advised to stay away from activities and exercises that worsen the symptoms or worsen the pain. Contact sports should be avoided until the symptoms show some improvement and the normal activities should be handled as tolerated.

Mediation such as non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen can be used in the management of the condition. Costochondritis may be treated using steroid injection and local anesthetic in the affected area especially in cases where normal activities are difficult to complete as a result of pain that does not positively respond to other types of medications. If the costochondritis is as a result of fungal or bacterial infection, then the condition can be treated using antibiotics.

Costochondritis Prognosis

Costochondritis that is not caused by infections is self limiting. This simply means tat without any other underlying conditions; the pain and the symptoms will go away with or without anti-inflammation treatment. Most patients will fully recover, the symptoms will disappear and they will be back to their daily life activities as usual. If the condition is caused by infections, it will be successfully managed and eliminated through intravenous (IV) antibiotics as well as surgical repair.

Because of the fact that costochondritis has symptoms that can resemble those of a serious illness such as a heart disease, it is important that any individual with chest pains and related symptoms sees a doctor immediately. This is for early diagnosis, treatment of any underlying condition and elimination of the symptoms so that the patient can return to their normal lives.

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