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In costochondritis and Tietze syndrome, inflammation of the costal cartilage occurs. [4] This is a common cause of chest pain. [5] Severe trauma may lead to fracture of the costal cartilage. [6] Such injuries often go unnoticed during x-ray scans, but can be diagnosed with CT scans. [6]
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]
The costochondral joints are the joints between the ribs and costal cartilage in the front of the rib cage. They are hyaline cartilaginous joints (i.e. synchondrosis or primary cartilagenous joint). Each rib has a depression shaped like a cup that the costal cartilage articulates with. There is normally no movement at these joints.
Costochondritis is most commonly confused with Tietze syndrome, as they have similar symptoms and can both affect the costochondral and sternocostal joints. Costochondritis is considered a more common condition and is not associated with any swelling to the affected joints, which is the defining distinction between the two.
Rib resection differentiates from costal cartilage removal as it removes a small bone portion of the affected rib(s). [1] Laparoscopic costal cartilage removal is a minimally invasive, intra-abdominal approach to treating the condition. The affected cartilage is excised from the sternocostal junction to the costochondral junction. [17]
The only exception is the first rib, which has a synchondrosis joint since the cartilage is directly united with the sternum. [1] The sternocostal joints are important for thoracic wall mobility. [2] The ligaments connecting them are: Articular capsules; Intraarticular sternocostal ligament; Radiate sternocostal ligaments; Costoxiphoid ligaments
Rachitic rosary is due to a deficiency of calcium resulting in lack of mineralization and an overgrowth of costochondral joint cartilage. The calcium deficiency may be caused by rickets or other causes of calcium deficiency such as hypoparathyroidism .
The costal margin may be used for tissue harvesting of cartilage for use elsewhere in the body, such as to treat microtia. [4] Different abdominal organs may be palpated just below the costal margin, such as the liver on the right side of the body. [5] Pain across the costal margin is most commonly caused by costochondritis. [6]