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.
John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
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.
What causes costochondritis?
The causes of costochondritis are not known and may involve several factors. Possible causes include heredity (genetic predisposition), viruses, and trauma (injury).
Costochondritis is distinguished from Tietze's syndrome, a condition also involving the same area of the front of the chest, by the presence of swelling. Costochondritis is not associated with swelling, as opposed to Tietze's syndrome, where swelling is characteristic. Tietze's syndrome is an inflammation of the costochondral cartilages of the upper front of the chest that involves
swelling of the joint.
While both costochondritis and Tietze's syndrome feature localized pain and tenderness in the front of the chest, Tietze's syndrome also causes swelling over the ribs and cartilage near the breastbone (sternum). Redness, tenderness, and warmth 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's syndrome, whereas patients with costochondritis alone typically have normal tests for inflammation.
Reviewed by John P. Cunha, DO, FACOEP on 9/13/2012
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.
A sedimentation rate is common
blood test that is used to detect and monitor inflammation in the body. The sedimentation rate is also called the
erythrocyte sedimentation rate because it is a measure of "...