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Costochondritis, also known as chest wall pain syndrome or costosternal syndrome, is a benign inflammation of the upper costochondral (rib to cartilage) and sternocostal (cartilage to sternum) joints. 90% of patients are affected in multiple ribs on a single side, typically at the 2nd to 5th ribs. [1]
It lies superficially and parallel to the sternum. Its origin and insertion are variable. The sternalis muscle often originates from the upper part of the sternum and can display varying insertions such as the pectoral fascia, lower ribs, costal cartilages, rectus sheath, aponeurosis of the abdominal external oblique muscle.
The injury is characterized by sudden and acute pain in the chest wall and shoulder area, bruising and loss of strength of the muscle. High grade partial or full thickness tears warrant surgical repair as the preferred treatment if function is to be preserved, particularly in the athletic population.
Symptoms associated with xiphoidalgia may include abdominal pain, chest discomfort, nausea, and radiating pain extending to the back, neck, and shoulders. Activities such as lifting heavy objects or chest trauma may precipitate this musculoskeletal ailment, and symptoms may intensify with bending or twisting.
In environments such as the emergency department, an estimated 20-50% of non-cardiac chest pain is due to a musculoskeletal cause. [1] Despite musculoskeletal conditions such as Tietze syndrome being a common reason for visits to the emergency room, they are frequently misdiagnosed as angina pectoris , pleurisy , and other serious ...
The pain is agitated by expansion and contraction of the chest. Taking a deep breath and allowing the rib cage to fully expand can relieve the pain, however it will feel unpleasant initially. At the point of full expansion, it can feel like a rubber band snap in the chest, after which the initial pain subsides.
Overall chest pain is a symptom of up to 48% of sudden-onset panic attacks, and 10% of gradual-onset panic attacks. [12] Anxiety: Generalized anxiety disorder (GAD) is characterized by persistent and excessive worry, often accompanied by physical symptoms such as chest pain, restlessness, fatigue, and muscle tension [34]
Costochondritis is a common cause of chest pain, consisting of up to 30% of chest pain complaints in emergency departments. The pain is typically diffused with the upper costochondral or sternocostal junctions most frequently involved, unlike slipping rib syndrome, which involves the lower rib cage.
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