Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Dr. Lee was born in Shanghai, China, and received his college and medical training in the United States. He is fluent in English and three Chinese dialects. He graduated with chemistry departmental honors from Harvey Mudd College. He was appointed president of AOA society at UCLA School of Medicine. He underwent internal medicine residency and gastroenterology fellowship training at Cedars Sinai Medical Center.
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
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 oilscan have a degree of antiinflammation effect. Theoretically they could be of some benefit. This effect is probably minor, however.
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 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.
Angina is chest pain that is due to an inadequate supply of oxygen to the heart muscle.
Angina can be caused by coronary artery disease or spasm of the coronary
arteries. EKG, exercise treadmill, stress echocardiography, stress thallium, and cardiac
catheterization are important tests used in the diagnosis of angina.
Chest pain is a common complaint by a patient in the ER. Causes of chest pain include broken or bruised ribs, pleurisy, pneumothorax, shingles, pneumonia, pulmonary embolism, angina, heart attack, costochondritis, pericarditis, aorta or aortic dissection, and reflux esophagitis. Diagnosis and treatment of chest pain depends upon the cause and clinical presentation of the patient's chest pain.
Ankylosing spondylitis is a type of arthritis that causes chronic inflammation of the spine. The tendency to develop ankylosing spondylitis is genetically inherited.
