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
 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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Costochondritis and Tietze Syndrome
Chest Pain »
Introduction
Chest pain is one of the most common complaints that will bring a patient to
the Emergency Department. Seeking immediate care may be lifesaving, and
considerable public education has been undertaken to get patients to access
medical care when chest pain strikes. While the patient may be worried about a
heart attack, there are many other causes of pain in the chest that the healthcare provider will need to consider. Some diagnoses are life threatening, while
others are less dangerous.
Deciding the cause of chest pain is sometimes very difficult and may require
blood tests, x-rays, CT scans and
other tests to sort out the diagnosis. Often though,
a careful history taken by the healthcare provider may be all that is needed to find
the answer.
What are the sources of chest pain?
The source of pain may arise from a variety of potential sources:
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