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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]
Conservative measures are often the first forms of treatment offered to patients with slipping rib syndrome, especially those in which symptoms are minor. [16] Often the patients will be reassured and recommended to limit activity, use ice, and take pain medication such as nonsteroidal anti-inflammatory drugs (NSAIDs). [4]
The first seven pairs are connected with the sternum; the next three are each articulated with the lower border of the cartilage of the preceding rib; the last two have pointed extremities, which end in the wall of the abdomen.
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.
Treatment is usually via reassurance, as the pain generally resolves without any specific treatment. Occasionally it goes away after a couple of breaths. [1] 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.
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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.
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