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Costochondritis & Tietze Syndrome

Medical Author: William C. Shiel Jr., MD, FACP, FACR
Medical Editor: Dennis Lee, MD

What causes costochondritis? Is there anything that aggravates it (like exercise or diet), or is it possibly viral?

Medical Author: William C. Shiel Jr., MD, FACP, FACR

Read about causes of costochondritis.Costochondritis can be aggravated by any activity that involves stressing the structures of the front of the chest cage. It is generally best to minimize these activities until the inflammation of the rib and cartilage areas has subsided.

I am unaware of any particular diet causing worsening of costochondritis. On the contrary, it is known that fish oils can have a degree of antiinflammation effect. Theoretically they could be of some benefit. This effect is probably minor, however.

What is costochondritis?

Costochondritis is a common form of inflammation of the cartilage where ribs attach to the breastbone, the sternum. The inflammation can involve multiple cartilage areas on both sides of the sternum but usually is on one side only.

The cause(s) of costochondritis is(are) not known and may involve several factors. Possible causes include heredity (genetic predisposition), viruses, and trauma (injury).

Costochondritis can be an independent condition by itself or sometimes be a feature of a more widespread disorder. Examples of illnesses that can feature costochondritis include fibromyalgia, psoriatic arthritis, ankylosing spondylitis, reactive arthritis, and inflammatory bowel disease (such as ulcerative colitis and Crohn's disease).

What is the Tietze syndrome?

Costochondritis should be distinguished from Tietze syndrome, a condition involving the same area of the front of the chest. Costochondritis is not associated with swelling, as opposed to Tietze syndrome where swelling is characteristic. Tietze syndrome is an inflammation of the costochondral cartilages of the upper front of the chest.

Patients with Tietze syndrome develop tenderness and swelling over the ribs and cartilage near the breast bone (sternum). Redness, tenderness, and heat can also be present, but a localized swelling is the distinguishing finding. The pain is variable, often sharp, can be confused with heart pain, and can last from hours to weeks. It can cause difficulty with sleeping and even rolling over in bed is sometimes painful. Blood testing (sedimentation rate or C-reactive protein test) can show signs of inflammation in patients with Tietze syndrome, whereas patients with costochondritis alone typically have normal tests for inflammation.



Next: What is the treatment for costochondritis and Tietze syndrome? »

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