Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Costochondritis, also known as chest wall pain syndrome, is the inflammation of the cartilage of the rib cage. Chest pain near thesternum(breastbone) is the primary symptom. It is sometimes severe enough for people to seek emergency care because it can mimic a heart attack.
The cause of costochondritis is often unknown but may be the result of repetitive microtrauma to the chest wall. Though the symptoms tend to resolve on their own without consequence,nonsteroidal anti-inflammatory drugs (NSAIDs)andice therapycan help ease the pain.
Verywell / Gary Ferster
In their totality, symptoms like these are easily mistaken for aheart attack. Studies have shown that more than 55% of emergency room visits are due to non-heart-related chest pain mistaken for a heart attack.
Causes and Risk Factors
The cause of costochondritis is poorly understood but is thought to be due to a prior injury sustained in thecostochondraljoints (situated between the rib bones and cartilage in the front of the chest) and/or thesternocostaljoints (situated between the rib bones and the sternum).
These tiny breaks and cracks, called microtraumas, can cause scar tissue that makes joint cartilage less flexible. Coughing and exercise can place extreme stress on these tissues, which the body will respond to with inflammation.
Common causes of costochondritis include:
Costochondritis can also sometimes occur with different types ofinflammatory arthritis, includingrheumatoid arthritis,ankylosing spondylitis, andpsoriatic arthritis.
How Common Is Costochondritis?Costochondritis is a common condition that accounts for 20% to 50% of acute chest pain-related symptoms in adults. Females are slightly more affected than males. Most cases are seen between the ages of 40 and 50.
How Common Is Costochondritis?
Costochondritis is a common condition that accounts for 20% to 50% of acute chest pain-related symptoms in adults. Females are slightly more affected than males. Most cases are seen between the ages of 40 and 50.
Costochondritis is typically diagnosed based on a review of your symptoms and medical history, a physical exam, and the exclusion of all other causes. There is no single test that can diagnose costochondritis and those ordered are often used to rule out mimicking conditions.
As part of the evaluation, the healthcare provider may perform in-office manipulations, such as the “crowing rooster maneuver” (in which both of your hands are clasped behind your head) and “cross-chest adduction” (in which your arm is pulled horizontally across the chest) to see if they trigger costochondritis symptoms.
Other tests may be used as part of the evaluation, including:
Differential Diagnosis
Central to the diagnosis of costochondritis is thedifferential diagnosis. This is the process used to investigate and weed out other possible causes of your symptoms.
To definitively diagnose costochondritis, a healthcare provider will want to exclude, among other things:
Costchondritis vs. Tietze SyndromeCostochondritis is often confused withTietze syndrome, a benign condition that causes the swelling of cartilage in the rib cage. Although microtraumas are also thought to cause Tietze syndrome, the condition tends to be limited to the second and third ribs closer to the shoulder and causes visible swelling both on X-ray and sometimes on visual examination.
Costchondritis vs. Tietze Syndrome
Costochondritis is often confused withTietze syndrome, a benign condition that causes the swelling of cartilage in the rib cage. Although microtraumas are also thought to cause Tietze syndrome, the condition tends to be limited to the second and third ribs closer to the shoulder and causes visible swelling both on X-ray and sometimes on visual examination.
Costochondritis is most often a self-limiting condition that goes away on its own. With that said, symptoms may last for days, a few weeks, or up to several months.
To help ease pain and reduce inflammation, treatment options include:
Summary
Costochondritis is the acute inflammation of cartilage in the rib cage. It is typically a non-serious, self-limiting condition that goes away on its own. Even so, costochondritis can cause significant pain around the middle of the chest, sometimes lasting for months. The pain is often felt on the left side near the breastbone and gets worse when coughing, exercising, or taking a deep breath.
Rest, ice application, and nonsteroidal anti-inflammatory drugs can help ease symptoms. Severe cases may benefit from a local shot of cortisone.
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Icahn School of Medicine at Mount Sinai.Costochondritis.MedlinePlus.Costochondritis.Mott T, Jones G, Roman K.Costochondritis: rapid evidence review.Am Fam Physician.2021;104(1):73-78.Newman DP, Jansen BJ, Scozzafava A, Smith R, McLean BC.Rib mediated non-cardiac chest pain: a case report.Cureus. 2020 Oct 6;12(10):e10831. doi:10.7759/cureus.10831Mokraoui NR, Ganim R, Paez A.Chest wall abscess and costochondritis due toSalmonella entericaserotype Choleraesuis: a case report.J Med Case Rep. 2023 Dec 6;17:502. doi:10.1186/s13256-023-04229-wDong T, Parizher G, Jaber WA.Triaging down the 2021 chest pain guidelines.JACC Case Rep.2022 Jan 5;4(1):13–20. doi:10.1016/j.jaccas.2021.12.003National Organization for Rare Disorders.Tietze syndrome.
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Icahn School of Medicine at Mount Sinai.Costochondritis.MedlinePlus.Costochondritis.Mott T, Jones G, Roman K.Costochondritis: rapid evidence review.Am Fam Physician.2021;104(1):73-78.Newman DP, Jansen BJ, Scozzafava A, Smith R, McLean BC.Rib mediated non-cardiac chest pain: a case report.Cureus. 2020 Oct 6;12(10):e10831. doi:10.7759/cureus.10831Mokraoui NR, Ganim R, Paez A.Chest wall abscess and costochondritis due toSalmonella entericaserotype Choleraesuis: a case report.J Med Case Rep. 2023 Dec 6;17:502. doi:10.1186/s13256-023-04229-wDong T, Parizher G, Jaber WA.Triaging down the 2021 chest pain guidelines.JACC Case Rep.2022 Jan 5;4(1):13–20. doi:10.1016/j.jaccas.2021.12.003National Organization for Rare Disorders.Tietze syndrome.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Icahn School of Medicine at Mount Sinai.Costochondritis.MedlinePlus.Costochondritis.Mott T, Jones G, Roman K.Costochondritis: rapid evidence review.Am Fam Physician.2021;104(1):73-78.Newman DP, Jansen BJ, Scozzafava A, Smith R, McLean BC.Rib mediated non-cardiac chest pain: a case report.Cureus. 2020 Oct 6;12(10):e10831. doi:10.7759/cureus.10831Mokraoui NR, Ganim R, Paez A.Chest wall abscess and costochondritis due toSalmonella entericaserotype Choleraesuis: a case report.J Med Case Rep. 2023 Dec 6;17:502. doi:10.1186/s13256-023-04229-wDong T, Parizher G, Jaber WA.Triaging down the 2021 chest pain guidelines.JACC Case Rep.2022 Jan 5;4(1):13–20. doi:10.1016/j.jaccas.2021.12.003National Organization for Rare Disorders.Tietze syndrome.
Icahn School of Medicine at Mount Sinai.Costochondritis.
MedlinePlus.Costochondritis.
Mott T, Jones G, Roman K.Costochondritis: rapid evidence review.Am Fam Physician.2021;104(1):73-78.
Newman DP, Jansen BJ, Scozzafava A, Smith R, McLean BC.Rib mediated non-cardiac chest pain: a case report.Cureus. 2020 Oct 6;12(10):e10831. doi:10.7759/cureus.10831
Mokraoui NR, Ganim R, Paez A.Chest wall abscess and costochondritis due toSalmonella entericaserotype Choleraesuis: a case report.J Med Case Rep. 2023 Dec 6;17:502. doi:10.1186/s13256-023-04229-w
Dong T, Parizher G, Jaber WA.Triaging down the 2021 chest pain guidelines.JACC Case Rep.2022 Jan 5;4(1):13–20. doi:10.1016/j.jaccas.2021.12.003
National Organization for Rare Disorders.Tietze syndrome.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
