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Costochondritis is an inflammation of the junctions where the upper ribs join with the cartilage that holds them to the breastbone or sternum. It is, in fact, an inflammation of the connective tissue between the breastbone and the ribs.

What exactly is cartilage? Cartilage is a tough rubbery tissue that lines and cushions the surfaces of joints. Although most of the people think that every pain in the chest is linked to the myocardial ischemia or infarction, this condition also causes localized chest pain that you can reproduce by pushing on the cartilage in the front of your ribcage.[1]


The pain may be more noticeable in sitting or reclining positions, and stress is known to aggravate it. The fact is that costochondritis is a relatively harmless condition and usually goes away without treatment. It is never accompanied by swelling. The inflammation can involve cartilage areas on both sides of the sternum, but usually, it is located on the one side only. It is a very similar condition to a disease called Tietze's syndrome, with only one difference - Tietze's includes swelling. The discomfort of costochondritis often lasts a few days only.[2]

Incidence of the condition

Costochondritis is a common cause of chest pain in children and adolescents. In fact, it accounts for 10-30% of all chest pain in children. Doctors evaluate that there are about 650,000 cases of chest pain in young people aged 10-21 years annually. The peak age for the condition is 12-14 years.

Symptoms of costochondritis

Costochondritis is a specific condition which is characterized by pain and tenderness in the places where ribs attach to the breastbone. In most cases, the pain is sharp, though it can also feel like a dull, gnawing pain. Any of the 7 costo-chondral junctions may be affected, and more than 1 site is affected in 90% of cases. Pain associated with costochondritis occurs more often on the left side of your breastbone, though it can occur on either side of your chest.[2]

Pain may radiate to the back or abdomen. The most common site of pain is fourth, fifth, and sixth rib and it increases as you move your trunk or take deep breaths. Conversely, it decreases as your movement stops or on quiet breathing.

Other signs and symptoms of costochondritis may include:

  • Pain when taking deep breaths
  • Pain when coughing
  • Difficulty breathing
  • The reproducible tenderness you feel when you press on the rib joints is a constant feature of costochondritis. Without this tenderness, a diagnosis of costochondritis is unlikely.

When called Tietze's syndrome, the pain is accompanied by redness and/or swelling in the most tender areas. When associated with an autoimmune disease such as PBC, it may linger for years or a lifetime.

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