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What is Costochondritis? (with pictures)

Inflammation of the cartilage in between the ribs and the breastbone is called costochondritis. It may also be known as costosternal chondrodynia, costosternal syndrome or by the much easier to pronounce chest wall pain. When this inflammation occurs it quite painful especially right at the breastbone and the cartilage where they join with the ribs, and it can scare a lot of people into thinking they are having a heart attack. It’s a good idea not to sit at home trying to figure this out on your own, since you wouldn’t want to guess wrong. Though a heart attack typically is more painful during exertion, and is painful over a larger area of the chest, it’s simply risky not to see a doctor if you’re suffering from chest pain.

Pain in the chest from costochondritis is hard not to notice, and usually sends most people to the doctors in any case. Once there, doctors tend to diagnose the condition by taking patient history, examining the breastbone to see if pressure creates more pain, and they may also do tests to rule out other conditions. You usually can’t see the inflammation on an X-ray, so diagnosis tends to occur by process of elimination or when there is a clear causal factor.

Costochondritis symptoms are often most felt when you are taking deep breaths, or if you are coughing. Additionally, some people have trouble breathing. Causes of the condition can vary and it can affect children or adults.

A known injury to the chest wall can cause costochondritis, but so can some bloodstream infections or infections of the sternum. People who have recently had chest or heart surgery may develop the condition after surgery. Sometimes people with conditions like fibromyalgia get this condition too, and occasionally fibromyalgia is diagnosed when people have recurrent costochondritis. There are times when doctors don’t know what causes it, and the condition clears on its own after a few days or even a few weeks of rest.

Basic treatments for the condition depend on causes. Most important is making certain that pain is managed. For many people this will mean taking over the counter non-steroidal anti-inflammatories like ibuprofen. Some people may need stronger narcotic based pain relievers. If the causes of costochondritis are known, additional treatment may be necessary to treat the root cause.

In rare instance the breastbone remains extremely painful and the condition does not go away. Under these circumstances, since pain can seriously impact daily living, doctors may remove the sore areas of cartilage to resolve the condition. Most people do recover without this step, usually within a few weeks of emergence of symptoms. It is important to get plenty of rest. Using a heating pad a few times a day on the breastbone can help, but if the condition resulted from chest surgery, you should consult your doctor regarding this home treatment.

Costochondritis | MyTeleHealth

What is it?

  • Pain caused by costochondritis may mimic that of a heart attack or other heart conditions.
  • Your doctor might refer to costochondritis by other names, including chest wall pain, costosternal syndrome and costosternal chondrodynia. When the pain of costochondritis is accompanied by swelling, it’s referred to as Tietze syndrome.
  • Most cases of costochondritis have no apparent cause. In these cases, treatment focuses on easing your pain while you wait for costochondritis to improve on its own.


Costochondritis is the most common cause of chest pain originating in the chest wall.

Symptoms include:

  • Pain and tenderness in the locations where your ribs attach to your breastbone (costosternal joints)
  • Often sharp pain, though also dull and gnawing pain
  • Location often on left side of breastbone, but possible on either side of chest

Other costochondritis symptoms may include:

  • Pain when taking deep breaths
  • Pain when coughing
  • Difficulty breathing


Doctors don’t know what causes most cases of costochondritis. Only some cases of costochondritis have a clear cause. Those causes include:

  • Injury. A blow to the chest could cause costochondritis.
  • Physical strain. Heavy lifting and strenuous exercise have been linked to costochondritis.
  • Upper respiratory illness. An infection that produces sneezing or a cough may produce costochondritis.
  • Infection. Infection can develop in the costosternal joint, causing pain.
  • Fibromyalgia. Recurring costochondritis could be a symptom of fibromyalgia. People with fibromyalgia often have several tender spots. The upper part of the breastbone is a common tender spot.
  • Pain from other areas of your body. Pain signals can sometimes be misinterpreted by your brain, causing pain in places far away from where the problem occurs. Your doctor might refer to this as “referred pain.” Pain in your chest can sometimes be caused by problems with the bones in your spine compressing the nerves.

Risk factors

Costochondritis occurs most often in women and in people older than 40. However, costochondritis can affect anyone, including infants and children.

Tests and diagnosis

Your doctor will conduct a physical exam to diagnose costochondritis. He or she will ask you to describe your pain and what influences it. The pain of costochondritis can be very similar to the pain associated with heart disease, lung disease, gastrointestinal problems and osteoarthritis. Your doctor will feel along your breastbone for areas of tenderness or swelling.

Costochondritis generally can’t be seen on chest X-rays or other imaging tests used to see inside your body. Sometimes your doctor orders these tests or others to rule out other conditions.

Treatments and drugs

Costochondritis usually goes away on its own and is short-lived, although in some cases it may last for several months or longer.

To ease your pain until it fades, your doctor may recommend:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen
  • Antidepressants, specifically a category of medicines called tricyclic antidepressants, if pain is making it difficult to sleep at night
  • Muscle relaxants, which can also help ease pain

Lifestyle remedies

It can be frustrating to know that there’s little your doctor can do to treat your costochondritis. But you can take self-care measures to make yourself more comfortable, which can give you a greater sense of control over your condition. To help relieve the pain of costochondritis, try to:

  • Rest. Avoid activities that make your pain worse.
  • Exercise. It may seem contradictory to rest, but gentle exercises, such as walking or swimming, can improve your mood and keep your body healthy. Don’t overdo it, and stop if exercise increases your pain.
  • Use a heating pad. Apply a heating pad to the painful area several times a day. Keep the heat on a low setting.

Once your pain is gone, continue taking it easy. Slowly work your way back to your normal activities.


Although the cause of costochondritis is often unknown, there’s some evidence that children who carry a heavy school bag, especially over one shoulder, are at increased risk of this condition. Upper respiratory infections, heavy lifting and strenuous exercise also may be linked to costochondritis.

Common-sense preventive steps that may reduce the risk of costochondritis and protect you and your family’s overall health include:

  • Encourage your child to use school bags properly. Make sure your child’s bag is not so heavy that your child’s shoulders slump, and show your child how to carry the bag appropriately.
  • Avoid activities that seem to trigger costochondritis-like pain. If chest pain and tenderness seem to result from physical exertion, ask your doctor to provide safe guidelines for your exercise program and for lifting.
  • Take steps to prevent respiratory infection. Wash your hands thoroughly and often, avoid sharing drinking glasses or utensils with others and limit your exposure to people who are ill.







Costal Cartilage Injuries – Radsource

Clinical History:

A 26 year-old football player presents with severe anterior chest pain following a tackling injury. MRI of the sternum was performed. A (1A) fat-suppressed T2-weighted coronal image and (1B,C) fat-suppressed proton density-weighted axial images are provided. What are the findings? What is your diagnosis?

1a 1b 1c Figure 1


2a 2b 2c Figure 2:

The (2A) fat-suppressed T2-weighted coronal image reveals a vertical fracture (arrow) involving the sternochondral junction of the left 1st rib. Sequential axial images through the area of injury reveal chondral separation (arrow) at the sternal attachment on the more cephalad slice (2B). On the more inferior slice (2C), the chondral fracture is redemonstrated and a triangular chondral fragment (arrowhead) remains firmly attached to the sternum. Soft-tissue edema compatible with contusion injury is also present (asterisks).


Acute fracture of the left medial 1st costal cartilage.


A wide variety of pathology may be seen at the ribs, including traumatic, neoplastic, infectious, and metabolic lesions. Following trauma, rib fractures are often suspected, and typically are readily identified on plain radiographs. The clinical presentation of costal cartilage injuries, however, may be identical to that of rib fractures, but cartilage injuries are not detectable with radiographs unless considerable costal calcification is present. Computed tomography and ultrasound have been reported as effective in revealing costal cartilage fractures. MRI, with its superior soft tissue contrast and proven ability to evaluate cartilage elsewhere in the musculoskeletal system, would be expected to be the best modality for the evaluation of costal cartilage. However, this approach has received little attention, with only a single published series by Subhas et al. found in the radiology literature.

Anatomy and function

The anatomy of the anterior ribs and costal cartilages is not widely recognized by many physicians. Because this region is infrequently imaged, many radiologists and even orthopaedic surgeons are surprised when visualizing the size of the costal cartilages at the anterior ribs. The anatomy is consistent. The costal cartilage of the 1st rib attaches to the manubrium, and the 2nd through 7th rib costal cartilages attach to the sternal body. The costal cartilages become increasingly wide from the 1st through 7th ribs. The 8th through 10th rib costal cartilages attach indirectly via a cartilage band that courses obliquely inferolaterally from the 7th rib. The last two ribs have no direct or indirect sternal attachment. The costal cartilages are a protective shock absorber for trauma to the anterior chest. Their flexibility also allows the ribcage to expand during respiration.

A 3D representation of the thorax demonstrates the normal anatomy of the costal cartilages. Illustration by Michael E. Stadnick, M.D.


MRI technique and normal appearance

MR imaging of costal cartilage can be challenging, as the ribs of course move with normal respiration. An effective technique in patients who can tolerate it is to position the patients prone using a spine or torso coil, which results in relatively less motion at the anterior chest. Generally acceptable results can be obtained with supine imaging as well, keeping imaging times relatively short, and when available, utilizing fast imaging techniques including breath-hold sequences. Another factor to remember is that because the chest contains the heart and great vessels, considerable pulsation artifact exists, and care must be taken to control the phase encoding direction, since pulsation artifact propagates in the phase encoding direction. As a result, axial images should be obtained with phase encoding right-left, and sagittal images with phase encoding superior-inferior, such that pulsation artifacts do not extend through the anterior chest wall (3).

3 Figure 3:

3A. A STIR axial image was performed with the phase encoding direction mistakenly set up as anterior-posterior. Although costal cartilage is visible (asterisks), it is suboptimally visualized, particularly on the left, as cardiac pulsation artifact propagates through the anterior chest wall.

In general, costal cartilage injuries are best evaluated with a combination of T1-weighted and fat-suppressed T2-weighted or STIR image contrast (4). Proton density fat-suppressed views are also effective for costal cartilage pathology. T1-weighted images reveal normal anatomy and are useful for marrow evaluation in ossified regions. The coronal plane tends to be the most effective though pathology can be confirmed with sagittal or axial views.

4a 4b Figure 4:

4A.B. Costal cartilages of the 2nd and 3rd ribs bilaterally demonstrate normal low signal intensity on T1 and fat-suppressed T2-weighted coronal images.

MR Imaging of Costochondral Injury

Costal cartilage injuries are most common in younger patients, as significant trauma, frequently sports-related, is a typical etiology. ,  In our practice at Radsource, the most frequent cause we see is a direct blow to the chest in American football players. The most frequently reported site of injury is the 1st or 2nd rib, and injuries commonly occur at the sternochondral or costochondral junctions. Subhas et al. reported a characteristic pattern of injury at the sternochondral junction of the 1st rib, in which a small triangular chondral fragment remains attached to the sternum. As in the test case and the case below, we have also recognized this pattern in our practice (5).

5a 5b Figure 5:

5A,B. Fat-suppressed T2-weighted coronal images from a NFL cornerback injured in a game. The upper image reveals sternochondral separation at the left clavicle (arrow) and a costal cartilage fracture at the left 1st rib with the typical attached triangular fragment (asterisk). An adjacent coronal slice reveals an irregular fracture of costal cartilage lateral to the sternal junction of the right 1st rib (arrow).

Costal cartilage fractures are thought to be common at the sternal junction of the upper ribs due to the relative immobility of the upper ribs, and such injuries often include a rotational component. In contrast, costal cartilage fractures of the lower ribs are more likely to be midsubstance and the result of a direct blow.6,

6 Figure 6:

6A. A fat-suppressed T2-weighted coronal image from a 49 year-old male who fell while water skiing at high speed. Linear mid-substance defects are present within the left 6th and 7th costal cartilages (arrowheads). The 6th rib cartilage fracture is mildly displaced. Associated soft tissue edema is also apparent.

7a 7b Figure 7:

7A,B. A 54 year-old male presents for abdominal MRI following a MVA resulting in left upper quadrant and anterior abdominal pain. (7A) T2-weighted and (7B) fat-suppressed T2-weighted anterior axial images reveal an unexpected midsubstance fracture of the costal cartilage of the left 8th rib (arrows).

When imaged with MR, costal cartilage injuries are typically seen early due to the pain associated with a traumatic event. In some cases, however, patients delay seeking treatment and present with persistent pain and swelling at the anterior chest (8). It has been speculated that chronic pain following a costal cartilage injury may be caused by an ineffective chondrocyte response to a cartilage fracture.7

8 Figure 8:

8A. A fat-suppressed T2-weighted coronal image in a 66 year-old male who complains of pain and swelling in the clavicle region following a fall 3 months earlier. A fracture near the sternochondral junction of the left 1st rib is apparent (arrow). Small adjacent fluid collections (arrowheads) are present and may be secondary to hemorrhage and/or instability.

Differential Diagnosis

Following a traumatic event, patients with anterior chest pain may of course have true osseous fractures rather than costal cartilage fractures. Similar MR imaging techniques can identify the fractures and confirm normal costal cartilage (9,10). Soft-tissue injuries in the region of the costal cartilages can also be readily identified with MRI (11).

9 Figure 9:

9A. A fat-suppressed T2-weighted coronal image in a patient 2 weeks following MVA with persistent chest wall pain reveals a comminuted sternal fracture (arrows). Costal cartilages demonstrate normal low signal intensity. A non-displaced fracture is present within the anterior left 3rd rib near the costochondral junction (arrowhead).

10a 10b Figure 10:

10B. Fat-suppressed T2-weighted images are provided from a 23 year-old male with right sided chest pain following an MVA. The (10A) straight coronal image demonstrates marrow edema within the anterior 7th and 8th ribs adjacent to the costochondral junction (arrows). An oblique coronal image (10B) through this area of interest reveals small fracture lines within both ribs (arrows) with normal appearing adjacent costal cartilage.

11a 11b Figure 11:

11A,B. Fat-suppressed proton density-weighted axial (11A) and sagittal (11B) images are provided from a 26 year-old professional football player with severe pain following a blow to the lower chest. Edema and fluid (arrows) surround a normal appearing left 9th costal cartilage. The findings are compatible with soft tissue contusion and hemorrhage.



Treatment of costal cartilage fractures is typically conservative, consisting of rest, ice, and nonsteroidal anti-inflammatory medications. Athletes are usually restricted from a return to the sport until pain has significantly subsided, and the length of time required varies from 2 weeks to several months. In professional athletes, rib protective clothing and anesthetic blocks may allow a more rapid return to play.



Costal cartilage fractures are an under-recognized cause of anterior chest pain following traumatic events, as they are typically not detectable on plain radiographs. This injury is thought to be relatively rare, but it is likely that it is more common than believed and that the entity is simply underdiagnosed. MRI is an effective tool for the evaluation of these injuries, providing greater conspicuity of injuries as compared to CT, and obviating the need for the specialized skill set required to make this diagnosis with ultrasound.



(PDF) A Case Report of Candida albicans Costochondritis after a Complicated Esophagectomy

www.PRSGlobalOpen.com 1

Osteomyelitis of the sternum and ribs is a well-

documented complication of surgery per-

formed using median sternotomy.1,2 However,

infection of the bone or cartilage of the chest wall is

rare after lateral thoracotomy, with fungal costochon-

dritis alone reported in a few cases.2,3 The majority of

instances of fungal costochondritis have occurred af-

ter the dissemination of candidiasis, in the setting of

intravenous heroin use.4,5 As this problem is rare af-

ter thoracotomy, information for guiding treatment

is sparse.2 Here, we report an unusual case of Candida

albicans costochondritis after Ivor Lewis esophagecto-

my and discuss possible diagnosis and management

options. To the best of our knowledge, this associa-

tion has not been previously reported.


A 69-year-old man, who had previously under-

gone 3 fundoplication procedures and a Collis

gastroplasty for gastroesophageal reflux, presented

with intractable esophageal dysmotility, gastroesoph-

ageal reflux, aspiration, and dysphagia. He had

distorted gastroesophageal anatomy, a distended in-

trathoracic post-Collis gastroplasty gastric segment,

and a failed fundoplication. Endoscopic esophageal

dilations yielded temporary relief of dysphagia but

failed to relieve the other symptoms.

After workup, he underwent an Ivor Lewis esoph-

agectomy via an upper midline abdominal incision

and right posterolateral thoracotomy via the sixth

intercostal space. This procedure was technically

challenging because of upper abdominal adhesions

and distorted anatomy, and the postoperative recov-

ery was complicated by an anastomotic leak on the

second postoperative day, which led to mediastinitis

and sepsis, requiring return to the operating theatre

on that day. After spending 40 days in the intensive

care unit with a prolonged and complicated recov-

ery and further 10 days on the surgical ward, he was

discharged from hospital.

Three months later, he represented with swelling,

erythema, and pain over the right costal margin, be-

low and medial to the end of the right thoracotomy

wound. On evaluation, costal osteomyelitis was sus-

pected, and a noncontrast CT was ordered. Results

of this investigation supported suspicions of osteo-

myelitis and/or osteochondritis. A bacterial cause

was assumed, and clindamycin 300 mg 3 times a day

was prescribed. Surgical options were initially de-

clined. Two months after commencing antibiotics,

Disclosure: The authors have no financial interest

to declare in relation to the content of this article. The

Article Processing Charge was paid for by the authors.

A Case Report of Candida albicans Costochondritis

after a Complicated Esophagectomy

Jake L. Nowicki, MD*

Nicola R. Dean, MBChB,

FRCS (Eng), FRACS (Plas)*†

David I. Watson, MD, FRACS,


Nowicki et al.

From the *Department of Surgery, Flinders University,

Flinders Medical Centre, Bedford Park, Adelaide, South

Australia, Australia; and †Department of Plastic and

Reconstructive Surgery, Flinders Medical Centre, Adelaide,

South Australia, Australia.

Received for publication November 4, 2015; accepted

December 22, 2015.

Copyright © 2016 The Authors. Published by Wolters

Kluwer Health, Inc. on behalf of The American Society of

Plastic Surgeons. All rights reserved. This is an open-access

article distributed under the terms of the Creative Commons

Attribution-Non Commercial-No Derivatives License 4.0

(CCBY-NC-ND), where it is permissible to download and

share the work provided it is properly cited. The work cannot

be changed in any way or used commercially.

DOI: 10.1097/GOX.0000000000000599

Summary: We present an unusual case of Candida albicans costochondritis

after a complicated Ivor Lewis esophagectomy. This case exhibits that

pain, erythema, and swelling over the costal cartilages should alert the

possibility of infective costochondritis, especially in a postoperative patient.

If a fungal agent is identified, aggressive surgical debridement and early

commencement of antifungal therapy are likely determinants for a satis-

factory outcome. (Plast Reconstr Surg Glob Open 2016;4:e608; doi: 10.1097/

GOX.0000000000000599; Published online 22 January 2016.)



Costochondritis in Lupus

Chest pain in Lupus – when is it due to costochondritis?

Chest pain in Lupus is a potentially serious condition and can arise because of different problems.
These include:

  • Pleurisy (inflammation of the lung lining)
  • Pulmonary Embolism (a blood clot)
  • Pericarditis (heart lining inflammation)
  • Myocardial infarction or angina due to narrowed or blocked coronary arteries

Any Lupus patient with chest pain should see a doctor right away and the above conditions should be
considered and excluded.

A common cause of pain in the anterior chest is costochondritis or inflammation at the insertions
(enthesis) of the ribs to the breastbone.

This page deals with this cause of chest pain that is not serious, but important to diagnose correctly for
correct treatment and to prevent unnecessary or invasive tests.

Since costochondritis is recurrent and can come on acutely, patients may have frequent emergency admissions
so it is important to prevent this.

Other Features of Costochondritis

Because of a “catching sensation” the patient may not breathe deeply enough and thus develop a sensation
of breathlessness. However, the lungs and heart are completely normal in costochondritis.

The vast majority of cases with costochondritis have no visible swelling at the rib insertion to the
breastbone (sternum).

Because the inflammation may be situated on the inner aspect of the ribs and breastbone the costochondritis
may not necessarily be associated with tenderness when the doctor examines the painful region.

In fact the pain can be poorly localised and this results in a careful search to exclude heart or lung disease.

Inflammation relating to the ribs may also be secondary to pain from enthesopathy at rib cage muscles.
Each rib from numbers 2 to 11 has at 3 muscles attached to both their top surface and bottom surface. This may be
associated with pain over the chest wall at a site well away from the breastbone and may also be hard to localise.

Finally rib enthesis pain may be arising from the joints that knit the ribs to the spine which are called the
costovertebral joints and the costotransverse joints.

Illustrative case

A 24 year old man with ANA positive Lupus with a titre of 1/2500 initially presented with a lupus facial rash
and hand joint pain and stiffness. He also had severe fatigue.

He was treated with hydroxychloroquine with dose stabilisation at 200mgs/day and had low dose corticosteroid

One year after the diagnosis he developed severe anterior chest pain that came on suddenly.

The pain was worse on breathing.

He experienced shortness of breath on exertion.

He was sent to hospital by his GP and was assessed for a pulmonary embolism.

His clinical examination was normal.

He had a normal ECG, a normal chest X-ray and a normal perfusion scan.

His blood investigations showed to evidence for the anti-phospholipid syndrome that predisposes to
clotting including pulmonary embolism.

He continued to feel left sided intermittent chest pain for 6 months.

When he was examined by the Rheumatologist he had no focal tenderness over the ribs at the anterior
chest wall and breastbone junction.

His ribcage and spine were also normal on examination.

He had no tenderness elsewhere.

The Rheumatologist could feel a “clunk” or “click” over the left side of chest likely indicating some
inflammation of the costochondral joints.

In view of the negative investigations and the clinical story and findings the patient was reassured
and advised to take painkillers as needed.


It is likely that the case above suffered from enthesitis or enthesopathy of the rib attachment to the
breast bone.

This can be difficult to diagnose as there is rarely obvious swelling.

Tenderness is variable and when absent making a diagnosis difficult.

So a high level of suspicion is needed.

Costochondritis in Lupus may be an incidental finding not related to the disease.

The case above was completely well otherwise which supports the idea that the costochondritis was
independent of the Lupus.

However, Lupus is a great mimic and can occasionally cause costochondritis.

The treatment is pain killers initially.

If a Rheumatologist or other specialist can localise a tender spot then this can be injected
with corticosteroids.

An accurate diagnosis helps alleviate patient anxiety about a more serious diagnosis.

The long term outcome for this condition is generally good.

X-Ray Exam: Chest (for Parents)

What It Is

A chest X-ray is a safe and painless test that uses a small amount of radiation to take a picture of a person’s chest. During the examination, an X-ray machine sends a beam of radiation through the chest, and an image is recorded on special film or a computer.

This image includes organs and structures such as the heart, lungs, large blood vessels, diaphragm, part of the airway, lymph nodes, the upper spine, ribs, collarbone, and breastbone.

The X-ray image is black and white. Dense body parts that block the passage of the X-ray beam through the body, such as the heart and bones, appear white on the X-ray image. Hollow body parts, such as the lungs, allow X-ray beams to pass through them and appear black.

An X-ray technician takes the X-rays. Usually, two are taken: one from the back of the chest if the child is old enough to stand up for the X-ray, and one from the side. In younger children a picture from the front of the chest is taken as well as from the side. In some cases, special views of the chest are taken.

Page 1

Why It’s Done

A chest X-ray is used to help find the cause of symptoms such as cough, shortness of breath, or chest pain. It can detect signs of asthma, pneumonia, a collapsed lung, heart problems (such as an enlarged heart), and broken ribs or lung damage after an injury.

Chest X-rays can reveal small metal objects (such as coins) that might have been swallowed. They can also help confirm that medical tubes have been placed in the right locations in the lungs, heart, blood vessels, or stomach.


A chest X-ray doesn’t require special preparation. Your child may be asked to remove all clothing and jewelry from the waist up and change into a hospital gown because buttons, zippers, clasps, or jewelry might interfere with the image.

Developing babies are more sensitive to radiation and are at more risk for harm, so if your daughter is pregnant, tell her doctor and the X-ray technician.


Although the procedure may take 15 minutes or longer from start to finish, the actual exposure time to radiation is usually less than half a second.

Your child will be asked to enter a special room that will most likely contain a table and a large X-ray machine hanging from the ceiling. Parents are usually able to accompany their child to provide reassurance and support.

A chest X-ray may be performed in a standing, sitting, or lying position. This will depend on the condition of your child and the reason for the X-ray. The technician will position your child, then step behind a wall or to an adjoining room to operate the machine.

Older kids will be asked to hold their breath and remain still for 2-3 seconds while the X-ray is taken; infants may require gentle restraint. Keeping the chest still is important to prevent blurring of the X-ray image. Two X-rays are usually taken, one from the back and one from the side.

If your child is in the hospital and cannot easily be brought to the radiology department, a portable X-ray machine can be brought to your child’s bedside. Portable X-rays are often used in emergency departments, intensive care units, or operating rooms. In this case, only one X-ray might be taken, usually from the front.

Page 2

What to Expect

Your child won’t feel anything as the X-ray is taken. The X-ray room may feel cool due to air conditioning used to maintain the equipment.

Positions required for the X-ray may feel uncomfortable, but they need to be held for only a few seconds. If your child has an injury and cannot stay in the required position, the technician might be able to find another position that’s easier on your child. Babies often cry in the X-ray room, especially if they’re restrained, but this won’t interfere with the procedure.

If you stay in the room while the X-ray is being done, you’ll be asked to wear a lead apron to protect certain parts of your body. Your child’s reproductive organs will also be protected with a lead shield.

After the X-rays are taken, you and your child will be asked to wait a few minutes while the images are processed. If they are blurred or unclear, the X-rays may need to be redone.

Getting the Results

The X-rays will be looked at by a radiologist (a doctor who is specially trained in reading and interpreting X-ray images). The radiologist will send a report to your child’s doctor, who will discuss the results with you and explain what they mean.

In an emergency, the results of a chest X-ray can be available within a short period of time. Otherwise, results are usually ready in 1 or 2 days. In most cases, results cannot be given directly to the patient or family at the time of the test.


In general, chest X-rays are very safe. Although any exposure to radiation poses some risk to the body, the amount used in a chest X-ray is small and not considered dangerous. It’s important to know that radiologists use the minimum amount of radiation required to get the best results.

Developing babies are more sensitive to radiation and are at greater risk for harm, so if your daughter is pregnant, make sure to inform her doctor and the X-ray technician.

Helping Your Child

You can help your young child prepare for a chest X-ray by explaining the test in simple terms before the procedure. It may help to explain that getting an X-ray is much like posing for a picture. You can describe the room and the equipment that will be used, and reassure your child that you’ll be right there for support.

For older kids, be sure to explain the importance of keeping still while the X-ray is taken so it won’t have to be repeated.

If You Have Questions

If you have questions about why the chest X-ray is needed, speak with the doctor. You can also talk to the X-ray technician before the procedure.

How It Happened and What I Did in Response

I was put on biologic medicine to treat ankylosing spondylitis a little over a year ago. I started the biweekly injections and slathered myself in hand sanitizer everywhere I went. Living in New York City, I’m surprised I wasn’t sicker more often!

Everyone warned me that biologics were the gateway to getting super sick (because they suppress the immune system), so it was almost as though I was waiting for an infection.

To be clear, biologics don’t cause illness or infection — but they can make you more vulnerable.

About three months into treatment (after seven or eight injections), I went to my swimming class and noticed that my ribs hurt — a lot. I thought, Did I pull something? Did I scrape my rib cage against the pool’s wall or something? 

After class, I went home feeling pretty exhausted and weak. I noticed that my rib cage was swollen, but I thought maybe I had costochondritis, which AS patients often get. If you’re lucky enough to not have had it, it’s inflammation where the upper ribs join the cartilage of the sternum. Fun!

The next morning, I woke up and my ribs hurt even worse. I planned to get an X-ray, but I emailed my rheumatologist first. She asked me for a picture of my ribs. Odd, I thought. You can’t see a broken bone through the skin.

Sure enough, when I went to take the picture, I noticed a sprinkling of light red dots. This was at 10 a.m. She told me she thought I had shingles and immediately prescribed me Valtrex (valacyclovir hydrochloride).

By 3 p.m., the rash had spread all the way around my body to my back. By 9 p.m., my entire rib cage was on fire. She nailed it.

I was 32 years old. I always thought shingles were something you got when you were, well, older. However, before starting biologic treatment, I did a bunch of research and saw that it is a possibility at a younger age — especially when you’re immunocompromised. It’s caused by the varicella-zoster virus, which also causes chickenpox (which I had when I was 2).

So, how does it happen? According to the Mayo Clinic, “After you’ve had chickenpox, the virus lies inactive in nerve tissue near your spinal cord and brain. Years later, the virus may reactivate as shingles.”

Shingles is no joke, friends. The rash itself wasn’t too terrible, but the horrific nerve pain made my head spin. It felt, and I remember thinking this very clearly, like someone burning, punching, and cutting me at the same time. It was as if I were being electrocuted and nothing could stop the random zaps. At one moment in the depths of pain, I thought, “I won’t survive if this lasts more than a few days.” Luckily, the horrific pain lasted only about three or four days. I’ve been known to be melodramatic, but it truly isn’t fun!

Valtrex — or whatever antiviral medicine you’re prescribed — is a necessity. If you suspect you have shingles and are immunocompromised, get help immediately. Any delay in treatment can cause postherpetic neuralgia, which results in lasting pain from damaged nerve fibers. It may last weeks, months, or even years.

To treat the rash, I cleaned it with tea tree oil and witch hazel — which was both gross and sort of refreshing. The rash can become infected, which you want to avoid at all costs. I also took 1,000 mg of Lysine daily, which has been found to promote healing.

If you’re on biologics, or if you’re about to start them, make sure you’re in the know about potential risks. Luckily, my shingles experience wasn’t so bad — but others have had it worse. If you suspect even the slightest symptom, advocate for yourself and check it out.


Note: Ankylosing Spondylitis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Ankylosing Spondylitis News, or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to ankylosing spondylitis.

Tietze Syndrome | KinesioPro

For the first time, Tietze’s syndrome was described by the German surgeon Alexander Tietze in 1921. In Tietze syndrome, the third, fourth, and fifth costochondral joints are usually affected. Less commonly, the manubriosternal joint and the joint of the xiphoid process are affected. The disease is characterized by pain in the chest (with coughing and deep breathing) and morning stiffness, as well as local edema and hyperemia of the costal cartilage.

Joint edema distinguishes Tietze’s syndrome from costochondritis or chronic inflammation of the cartilage of one or more ribs at the junction of the sternum with the ribs.

Clinically relevant anatomy

The rib cage consists of the clavicle, the sternum and 24 ribs (12 ribs on each side). Ten of the 12 ribs are connected to the sternum by cartilage, the function of which is to make the rib cage flexible when breathing. Behind, the ribs are articulated with the vertebrae through the costal-vertebral joints (joints of the rib head and costo-transverse joints).

Epidemiology / Etiology

The etiology of Tietze’s syndrome is unknown.This problem often occurs in acute cases associated with viral infections of the respiratory tract. Also, the disease may be based on microtrauma of the costal-cartilaginous joints. Tietze syndrome can occur in children and adults. The ratio of men and women is 1: 1. More than 80% of patients have single and unilateral lesions.

Characteristics / Clinical presentation

Cartilage connects the sternum to the ribs and collarbone and allows the chest to move during breathing.Inflammation of the cartilage of one or more ribs causes swelling and redness of the skin. It is visible and tangible. The pain can be of varying intensity, but it usually intensifies with movements of the trunk, coughing, deep breathing, and exertion.

Friends, very soon, within the framework of the RehabTeam project, a seminar by Valentina Yudakova “Breast department (Block 1)” will take place. Learn more…

These problems appear gradually and after a few days they can spontaneously disappear, but sometimes they can take years to disappear.Even after spontaneous recovery, the disease may return, and pain may occur in the same or a different place. Pain can lead to disruption of normal movement in other joints, for example, movement of the shoulder can be accompanied by crepitus and pain. Patients with Tietze syndrome can experience a variety of functional limitations. Daily activities such as ironing, brushing hair, or lifting objects can be difficult.

Differential diagnosis

Possible differential diagnoses are:

  • Seronegative spondyloarthropathy.
  • Rheumatoid arthritis.
  • Xyphoidalgia.
  • Sliding rib syndrome.
  • Myelomalacia.
  • Neoplasms of bones and soft tissues.
  • Chondrosarcoma of the costochondral joints.
  • Costochondrite.
  • Tumors of the breast and / or lungs with extension to the costal cartilage.
  • Metastases of breast, kidney and prostate neoplasms.
  • Rib injury and painful rib swelling.
  • Arthritis of the sternoclavicular and manubriosternal joints.

Diagnostic procedures

Appropriate tests such as electrocardiography (ECG) and computed tomography (CT) are needed. They are used to rule out other diseases. Research suggests that this diagnosis is a diagnosis of exclusion. Plain radiographs are often normal / uninformative. CT can reveal sclerosis of the sternum, partial calcification of the costal cartilage, and soft tissue edema. A rib cartilage biopsy may show chronic inflammation with fibrosis and ossification.Gallium scans have been reported to have increased uptake, similar to costochondritis.

Evaluation scales
  • Visual analogue scale (VAS).
  • Numeric rating scale for pain.
  • McGill Pain Questionnaire (short form).


Physical examination reveals swelling of the affected area and sometimes hyperemia. Pain may occur during palpation of this area; the pectoralis major and minor muscles, sternum are also painful.

Pain can be reproduced by retraction, protraction, or elevation of the shoulder, or by deep inhalation. Tietze syndrome leads to a limitation of muscle strength and range of motion of the upper limbs. In such patients, the level of functional activity may decrease. Typically, difficulties arise when ironing, lifting objects, combing hair, but the violation of functionality is insignificant.

As mentioned above, if there is inflammation of the cartilage of one or more ribs, then you can talk about costochondritis, if there is also swelling / redness, which is very painful, then you can talk about Tietze’s syndrome.


Medical treatment includes relative rest for 4-6 weeks, injections of an anesthetic corticosteroid, local or oral analgesics, and other drugs, including sulfasalazine or Caspofungin in combination with fluconazole.

Physical therapy

Currently, there are no reliable clinical studies on the treatment of this disease. Treatment for Tietze syndrome is mostly symptomatic.

What can be done?

  • Reassure the patient by explaining what is happening to him.
  • It is important that the physiotherapist informs the person of the correct posture while sitting or performing daily activities. It is also important that the patient avoids repetitive movements / actions. In general, these patients need a good balance between exercise and rest.
  • The treatment program may include exercises to increase range of motion.Patients usually tolerate such exercises well, but if they aggravate the symptoms, then they should be abandoned or delayed.
  • Stretching of the pectoralis major muscle is helpful. You can stretch the pectoralis major by standing in a doorway with your forearms in place. You need to repeat this exercise several times a day for 1 or 2 minutes.
  • Use hot / cold compresses and massage to relieve pain and symptoms of muscle overload. A variety of sprays can also be used for this purpose.
  • Mobilization of the spine and ribs is also helpful. This will help to avoid chest rigidity and reduce complaints.
  • It is important to teach the patient about breathing and pain management techniques.
  • Shoulder and back exercises can be provocative and should only be prescribed if symptoms resolve.
  • Transcutaneous electrical stimulation and electroacupuncture can be used. In the latter case, an acupuncture needle is placed in the affected segment of the spine.
  • Injection therapy with local anesthetics or corticosteroids has previously been described as a treatment for chest pain associated with costochondral joints. Previous research has shown that dry acupuncture can be as effective as injection therapy in treating these conditions.
Source: Physiopedia – Tietzes.

gaz.wiki – gaz.wiki


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Cervical spine

Since these syndromes have an outwardly similar clinical picture, most English-language scientific works do not single out individual syndromes, but use the term “The thoracic outlet syndrome” (McKenzie K, Lin G, Tamir S., 2004).

The complexity of the diagnosis and treatment of tunnel syndromes of the scalene and pectoralis minor is due to the fact that the clinical picture is influenced by both the degree of compression of the trunks and bundles of the brachial plexus and muscular-fascial pain syndrome (Ferguson L.U., 2008, Stephanidi A.B., 2009). Due to the insufficient development of diagnostic criteria for the main forms of neuropathies, they are often diagnosed as vertebrogenic lesions of the roots and spinal nerves (Popelyansky Ya.Yu., 1989; Zhulev S.N., 2010).

It is advisable to include visual palpation diagnostics and manual muscle testing in the scheme of a comprehensive examination of patients with tunnel syndromes of the scalene and pectoralis minor muscles.
Treatment complex: relaxation of the respiratory diaphragm,

Patient Education for Optimal Diaphragmatic Breathing,

restoration of optimal posture and biomechanics of the cervical spine and shoulder girdle,

mobilization of nerve trunks


Symptoms of anterior scalene muscle syndrome:

  • Pain starting from the neck, shoulder girdle and radiating to ulnar of the surface of the arm .Patients complain that they are not able to work with their arms raised up, to lift weights.
  • Strengthening of pain associated with turning the head, movements of the neck, trunk, arms. At the same time, paresthesia in the arm and headache can be observed.
  • A characteristic symptom is limitation of movement of the head and neck to the healthy side, weakness of the arm muscles, especially the extensors, decreased tendon and periosteal reflexes, autonomic disorders: hyperhidrosis of the skin of the hands, its swelling.


The muscle is prone to spasm and shortening, which leads to a change in the position of the scapula, the pectoralis minor muscle causes a change in the position of the humerus head in the shoulder joint, disrupts the correspondence of the humerus head, the glenoid cavity of the scapula and the clavicular-acromial joint, which leads to overload of the cervical spine with performing movements of the upper shoulder girdle.

Symptoms in pectoralis syndrome:

  • Pain and paresthesia along the anterolateral surface of the chest and in the area of ​​the scapula.
  • Pain radiates along the inner surface of the shoulder, forearm, hand, provoked by the movement of the hand.
  • Movement disorders in the area of ​​innervation of the median nerve – weakness of II – III fingers of the hand,
  • Hypotension of the muscles of the upper limb girdle with limited movement in the shoulder joint,
  • Hypotension of thenar and hypotenar, venous insufficiency in the form of acrocyanosis, swelling of the forearm and hand.

Most common causes of breast pain | From the mouth of a doctor

Almost every woman at least once in her life has experienced pain in the chest area, also known as mastalgia.

The mammary glands are a weak point of the female body, which requires close attention.

The mammary glands are a weak point of the female body, which requires close attention.

The severity and localization of pain varies widely. The pain can be symmetrical, in one gland, armpit, etc.It can be soft, barely noticeable, or extremely pronounced, unbearable.

The most common causes of chest pain are described below.

Breast cysts

Changes in the ducts of the mammary glands or the mammary glands themselves can lead to a condition such as cysts.

They are felt as bumps in the region of the gland. Fluid-filled cysts can be soft or hard.

Pain often depends on the phase of the cycle, increasing towards menstruation. With the onset of menopause, they disappear.

Costo-sternal syndrome

Costochondritis or costo-sternum syndrome is a disease that affects the costo-sternum joints. Arthritis develops in these joints, i.e. their inflammation.

Pain worsens on inspiration, coughing, palpation of the joints. This syndrome is confused with chest pain because the mammary gland can cover the joints, which masks the picture as breast pain.

The condition develops more often in women after 40.

Fibrocystic breast disease

Fibrocystic process in the chest can cause lumps, edema or coma.This process is a mixture between the overgrowth of scar tissue and the accumulation of fluid in the form of cysts.

This condition is harmless and usually develops in women between the ages of 20 and 50. The frequency of occurrence can be up to 95%!


Mastitis is an infectious disease of the breast tissue. With it, inflammation and edema develop in the ducts and glands, which ensures the appearance of pain.

The wrong bra

In recent decades, this reason is gaining momentum, especially with the spread of push-ups and other technologies.If the bra sits too tightly, or the chest dangles in it, on the contrary, this can lead to various disorders in the gland, which is the cause of discomfort and pain.

Chest pain

Chest pain is a wide range of different pathologies. They can also disguise themselves as breast pain. The most common of this group are:

  • Angina
  • Pain with gallstone disease
  • Muscle pain
  • Shingles

Breast cancer

The most terrible and dangerous cause of chest pain is cancer.Pain is an optional companion of this oncological disease. Often they appear only at a later date.

You should see a doctor if:

  • You have found a new lump in the gland
  • Increased pain and / or changes in the size of the lump associated with the cycle stage
  • Changes in the nipple, especially its retraction
  • Discharge from the nipple, the most dangerous if they are bloody

Knowing the characteristics of your body is very important, especially in adulthood.To keep abreast of various diseases, to know how to prevent and prevent them, as well as to hear the latest news from the world of medicine, support the author with a like and a subscription. This is the best way to express your thanks.

Costochondritis Causes and Symptoms Diagnosis and Treatment of Costochondritis

Costochondritis is an inflammation of the joints where the upper ribs join the costal cartilage that attaches them to the sternum (sternum). Costochondritis causes localized chest wall pain and tenderness that can be reproduced by pressing on the involved cartilage in the front of the chest.Costochondritis is a relatively harmless musculoskeletal pain in the chest and usually resolves without treatment. The reason is usually unknown. Costochondritis affects women more often than men (70% versus 30%).

Costochondritis is an inflammatory process. However, there is usually no specific reason for this. Repeated minor trauma to the chest wall or viral respiratory infections can cause costochondritis. Rarely, costochondritis from bacterial infections can occur in people who use intravenous drugs or have had surgery on their upper chest.Costochondritis can also be a sign of recurrent polychondritis, reactive arthritis, fibromyalgia, and trauma.

Various types of infectious diseases can cause costochondritis, although this is rare.

Costochondritis can also occur with certain forms of arthritis, such as ankylosing spondylitis and psoriatic arthritis, and is sometimes associated with chest pain (sternum pain) in these conditions. Costochondritis can occur in people with fibromyalgia.

Call a healthcare professional for any of the following symptoms:

Go to the hospital emergency department if you have trouble breathing or have any of the following symptoms.These symptoms are usually not from costochondritis:

Costochondritis is diagnosed using history and physical examination rather than special laboratory or imaging tests. Tests are sometimes used to rule out other conditions that may have similar symptoms but are more dangerous, such as heart disease.

Physicians who treat costochondritis include general practitioners, including primary care physicians, family physicians and therapists, as well as orthopedists, rheumatologists, and physical therapists.Ancillary healthcare professionals who may be involved in the treatment of costochondritis include physical therapists and massage therapists.

Physiotherapy is sometimes used in more severe cases of costochondritis. Infectious costochondritis requires careful monitoring to prevent the spread or recurrence of the infection.

Since inflammatory costochondritis has no specific cause, there is no real way to prevent it.

The ribs are connected to the sternum by a tough protective tissue called cartilage.When this cartilage becomes inflamed, the condition is called costochondritis or chest wall pain.

Although this condition is usually temporary, it can be alarming because the pain can become so severe that it mimics a heart attack.

Doctors may also call costochondritis bone marrow syndrome or bone marrow chondrodynia. The condition usually resolves on its own with home treatments.

Injuries to the shoulder or neck resulting in pain on movement or to the chest wall

A physical examination to feel cartilage tenderness to the touch may also be performed.If a person has a heart attack or other type of heart disease, the cartilage in the chest is usually not sensitive to touch.

The doctor will also listen to the heart and lungs and check the skin for signs of infection. X-rays or other imaging studies do not show signs of costochondritis.

Doctors can usually diagnose a child, adolescent, or young adult by asking questions about their medical history and performing a physical exam. The doctor will often check the sensitivity of the chest cartilage as part of this.


According to an American family doctor, costochondritis can last from several weeks to months. It can also recur if it was caused by exercise or stress.

The condition usually lasts no more than one year. However, adolescents with costochondritis sometimes have longer-lasting symptoms.

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Cryoglobulinemia is a condition that occurs when a person lacks a protein in their blood called cryoglobulin. It can be caused by infection, connective tissue disease, certain cancers, and other causes. Symptoms include joint pain, weakness, and organ damage.Treatment is available depending on the type and cause.

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Manifestations and treatment of costochondritis


Costochondritis is an inflammatory disease that develops in the region of the junction of the sternum with the ribs. The second name is rib-sternum syndrome. It is often confused with myocardial infarction or angina pectoris because they feel very similar.

Usually this syndrome appears for unknown reasons and completely goes away on its own without treatment.

Why does it appear

Most often, the patient is diagnosed with idiopathic costochondritis. That is, its cause throughout the entire time of the disease remains unclear. Sometimes there are provoking factors that can cause inflammation.

Among them, arthritis or osteoarthritis, as well as its rheumatic variety, are most common. The second common cause is a viral disease, as well as an inflammatory process caused by fungal or bacterial infections.

Another common cause is tumors. They can be both malignant and benign. but most often it is the first type. Also, pain in the sternum appears as a result of metastasis of tumors that are located in other places.

Injury or physical strain are two more provoking factors. Injury can be from a car accident or from a fall from a height. The injury itself may not cause a fracture, but the injury resulting from it, without treatment, can provoke severe inflammation.

Women over 40 are at risk. It is in them that costochondritis develops most often and proceeds for a long time, with strong pain in the chest area.

How it manifests itself

Pain with costochondritis is of varying intensity. Moreover, it can appear both on the left and on the right side, which often gives a reason for contacting a cardiologist to take an ECG and check blood pressure.

Indeed, the painful sensations are so strong that sometimes they resemble a heart attack or an attack of angina pectoris.However, there are no changes on the ECG, and the unpleasant sensations themselves are not relieved with the help of nitroglycerin, as is usually the case with heart disease.

Pain can spread to several edges at once. Also, discomfort can occur on palpation. Sometimes this disease is confused with a bruise or even a fracture. To distinguish one from the other, you just need to take an x-ray as directed by a doctor.

With an advanced form of inflammation, the body temperature may rise, and redness also occurs at the junction of the sternum and ribs.After several days of taking drugs from the NSAID group, all symptoms disappear.

Other manifestations include local fever, slight swelling of soft tissues, pain on palpation and discomfort when trying to breathe or exhale, as well as when coughing.

This is another important symptom that can be misleading, as pain increases when coughing and during inhalation or exhalation with another common disease – intercostal neuralgia.


At the first symptoms of the disease, you should consult a doctor as soon as possible.It could be a traumatologist or a neurologist. Diagnosis is carried out by palpation, in which the patient notes an increase in pain. The doctor will also find out the presence of swelling at the site of inflammation.

To exclude myocardial infarction and other heart pathologies, the patient is advised to consult a cardiologist and undergo an ECG. X-rays are also recommended to rule out a fractured rib. But today there is not a single specific study that would help to make a diagnosis quickly and in one visit to the doctor.

How to get rid of

The symptoms of costochondritis in adolescents are no different from those in adults. Treatment of the disease is carried out only by a doctor. The main drugs for therapy are those that belong to the NSAID group. These are ortofen, diclofenac, naproxen and others like that.

In severe cases, corticosteroid preparations are used, which can be used in the form of tablets or ointments. Typically, drug-based analgesics are not prescribed in this case.The drugs should be taken strictly under medical supervision and should not exceed the prescribed dose.

After the acute inflammation has been relieved, a full course of physiotherapy with medicinal electrophoresis must be completed. In some cases, exercise therapy helps. The prognosis is always good. Complications never arise. The peculiarity of the disease is that an attack of pain may soon recur.

Costochondritis – causes and symptoms, diagnosis and treatment of costochondritis

Costochondritis is an inflammation of the cartilage that connects the sternum and ribs.

This condition is also known as rib-sternum syndrome.

The pain caused by costochondritis may resemble the pain of myocardial infarction or other heart disease.

A physician may use other terms to refer to costochondritis. Costochondritis should be distinguished from Tietze’s syndrome, which is characterized by swelling in the area of ​​the affected cartilage.

Costochondritis has no obvious cause in most cases. In these cases, treatment focuses on pain relief, and sometimes costochondritis will go away on its own.

Costochondritis causes and risk factors

In most cases, the cause of costochondritis remains unknown.

Sometimes costochondritis can be the result of the following diseases:

• Arthritis. Osteoarthritis, rheumatoid arthritis (RA), ankylosing spondylitis are associated with costochondritis in some people.
• Joint infection. Viral, bacterial, and fungal (aspergillus) infections of the joint can cause costochondritis.
• Tumors. Benign, primary malignant tumors or metastases can also cause costochondritis.
• Physical effort. Lifting weights, like severe coughing, can be associated with rib-sternum syndrome.
• Injury. A blow to the chest is one of the common causes of costochondritis.

Risk factors for costochondritis include female sex and age over 40. In comparison, Tietze syndrome occurs more often in people under 40. Some people with costochondritis also have depression and anxiety, which aggravate chest pain.

Symptoms of costochondritis

Pain associated with costochondritis, most often:

• Occurs to the left of the sternum.
• Captures multiple edges at once.
• Worse with deep inhalation and coughing.

When should I see a doctor?

If you experience chest pain, seek immediate medical attention. In this case, it is important to exclude potentially dangerous conditions such as myocardial infarction.

Diagnosis of costochondritis

During the examination, the doctor will palpate the area along the sternum to identify areas of swelling and tenderness. Your doctor may order a chest x-ray, electrocardiogram, or other tests to rule out heart attacks and other conditions that cause similar symptoms.There is no specific test for the diagnosis of costochondritis.

Treatment of costochondritis

Costochondritis can go away on its own, but in some cases it can bother patients for a long time. Treatment for costochondritis is aimed at relieving symptoms.

• OTC pain relievers. You can use non-steroidal anti-inflammatory drugs (NSAIDs) over the counter for pain relief. These include ibuprofen, naproxen and drugs based on them.
• Prescription pain relievers. Your doctor may prescribe stronger drugs after examining you and looking at your medical history. But they are associated with a greater risk of side effects. Prescription NSAIDs include drugs based on diclofenac, nimesulide, etc. In the USA, for example, narcotic analgesics such as oxycodone are often prescribed.
• Other drugs. Sometimes with rib-sternum syndrome, the antiepileptic drug gabapentin (Tebantin) is prescribed, which helps well with peripheral pain.Tricyclic antidepressants may be prescribed to control pain.
• Topically, ointments containing corticosteroids and topical topical anesthetics can be used. Corticosteroids in this case have a pronounced anti-inflammatory effect.

Other therapies include exercise therapy, transcutaneous electrical nerve stimulation (TENS), manual therapy, reflexology, and intra-articular corticosteroid injections. To alleviate the condition, it is worth giving up excessive exertion and rest.

Konstantin Mokanov: Master of Pharmacy and Professional Medical Translator

Costochondritis: Causes, Symptoms and Treatment

The ribs are connected to the rib cage by a tough protective tissue called cartilage. When this cartilage becomes inflamed, the condition is known as chonditis or chest pain.

Although this condition is usually temporary, it can be unsettling because the pain can become so severe that it mimics a heart attack.

Physicians may also refer to stochondronditis as boston syndrome or bostonar chondrodynia.The condition is usually resolved on its own with home treatments.

Fast Facts About Stochondrosis

  • In many cases, doctors do not know what causes stochondrosis.
  • Pain in the chest and sternum is the main symptom of stochondrosis.
  • The pain can be so severe that the person feels like they are having a heart attack.
  • Treatment includes anti-inflammatory drugs.

What causes stochondrosis?

Although the causes are often unknown, in some cases this condition may be the result of one or more of the following:

  • a medical history that causes a lot of cough
  • weightlifting or intense exercise involving the upper limbs and chest wall
  • carrying heavy bags such as a heavy backpack on one side or the other
  • with a large chest
  • a history of chest trauma or chest infections
  • undergoing surgery that affects the chest wall, such as a heart bypass

Doctors call costochondritis, which is not has known causes of idiopathic costochondritis.

Symptoms of stochondrosis

Skin discomfort and pain can be stabbing, burning or hurting in nature. The most affected ribs are from the second to the fifth.

Typically, the condition most commonly affects people over 40, according to a journal article. An estimated 13-36 percent of those seeking emergency care for chest pain experience stochondrosis.

The following activities usually aggravated pain associated with stochondrosis:

  • significant amount of cough
  • exercise
  • physical activity using upper shoulders such as lifting boxes

Pain associated with costochondritis usually occurs on the left side of the body. but can affect both sides.

Tietze syndrome

There is a variation of stochondrosis called Tietze syndrome. This condition causes pain associated with stochondrosis as well as swelling of the costal cartilage.

Tietze syndrome swelling affects at least one of the four upper ribs, usually the second or third ribs. Although the pain associated with costochondritis can go crazy, some people with Tietze syndrome still experience swelling.

Although doctors have not determined how common the condition is, they consider it to be a rare condition.Apart from pain and discomfort, this does not cause long-term harmful effects.

How is costochondritis treated?

Doctors usually treat stochondrosis conservatively. Resting and avoiding strenuous exercise that affects the chest wall can help. Thus, over-the-counter pain relievers such as ibuprofen or acetaminophen can be used.

Children under the age of 18 should not take aspirin due to the increased risk of Rey’s syndrome.

On rare occasions, your doctor may recommend injections of lidocaine or corticosteroids to reduce pain and inflammation.Other treatments that can help relieve chest pain include:

  • Applying moist heat with warm compresses.
  • Taking cough suppressants to relieve coughs and reduce pressure on cartilage.
  • Physical therapy to relieve tension in the chest wall.

If these treatments do not reduce the incidence of stochondrosis in a person, they should seek medical attention.

When to see a doctor

If a person has chest pain, they should not try to determine for themselves if it is a heart problem or costochondritis.Instead, they should seek immediate medical attention.

If a young person who is not at risk of a heart attack experiences these symptoms, they should seek emergency attention if their chest pain is severe and does not improve with rest.

If someone goes to the doctor for symptoms and has been diagnosed with stochondrosis, there are still some cases when the person needs to seek medical attention again. These include:

  • weak, dizziness, or dizziness
  • a feeling as if the heart is beating irregularly or too fast
  • pain that worsens over time or cannot be relieved by sick medicine
  • with shortness of breath
  • fever exceeding 100.4 ° F adult
  • cough with phlegm or blood

If chest pain radiates to the arms, neck, shoulder, jaw, or back, the person should see a doctor immediately.

How do doctors diagnose stochondrosis?

Doctors often diagnose stochondrosis by ruling out other potential causes of chest pain and discomfort associated with the condition. For example, if the person is over 35, the doctor may first want to rule out coronary artery disease (CAD) as a potential cause.

Individuals who are at risk for CAD, such as those with a family history, who are obese, or people who smoke, should usually have an electrocardiogram (EKG or EKG) and chest X-ray to check for CAD.

Other medical conditions that may strongly resemble costochondritis include:

  • arthritis of the shoulder or nearby joints
  • chest infections or cancer
  • fibromyalgia, a condition that causes nerve pain
  • flexed rib syndrome when the cartilage is supported too much Lots of mobility supporting ribs
  • Injuries to the shoulder or neck that cause pain to contact or travel to the chest wall

A physical examination may also be done to detect cartilage tenderness to the touch.If a person has a heart attack or other type of heart condition, the cartilage in the chest is usually not sensitive to touch.

The doctor will also listen to the heart and lungs and examine the skin for any signs of infection. No signs of stochondrosis were found on radiographs or other imaging studies.

Doctors can usually diagnose a child, teenager, or young adult by asking questions about their medical history and performing a physical exam. The doctor will often check for tenderness in the breast cartilage as part of this.


According to the words, costochondritis can last from several weeks to several months. It can also recur if caused by exercise or exertion.

The condition is usually no more than one year. However, adolescents with stochondrosis can sometimes have a longer period of symptoms.

Costal chondritis (Tietze’s syndrome): causes, symptoms, diagnosis and treatment

Among the many different diseases of the chest cavity, pathology is quite common, which can be easily confused with diseases of the lungs and heart, inflammatory processes in the bones and muscles, infectious and allergic character, as well as with purulent infections – such terrifying clinical manifestations are inherent in her.However, in reality, the severity of the symptoms does not correspond at all to the severity of the phenomena occurring in the chest. We are talking about a little-known disease – costal chondritis, which in medicine is still often called Titze’s syndrome.

Brief information

Literally, “chondritis” means cartilaginous inflammation, but in reality, doctors refer to this concept as any unspecified pathology occurring in the cartilaginous layer.

As is known from anatomy, the end section of the ribs, connected to the sternum, is based on just such a tissue, and this is where the disease develops.

  • Most often, the disease affects the second rib.
  • Less often the third and fourth ribs are covered.
  • And with only a 10% probability of illness, the first, fifth or sixth rib succumbs.

Men and women are equally susceptible to this disease. Most often, costal chondritis is diagnosed in people aged 20-40 years. That is why doctors consider this pathology a disease of the young.

The defect was described in 1921 by the German surgeon Titze, after whom, in fact, it got its name.By the way, in the medical literature, one more name for the disease is often found – perichondritis.

The main manifestation of pathology, the German doctor called pain in the chest, in the middle of the ribs. But today, doctors talk about many other symptoms that accompany the disease.

Causes of occurrence

Presumably Tietze’s syndrome can be provoked by:

  • regular ARVI, especially complicated bronchitis;
  • attacks of debilitating cough, which practically loosens the thoracic region;
  • systematic sports loads and rib injuries;
  • drug addiction and alcoholism;
  • a poor diet with a minimum amount of collagen, calcium and vitamins;
  • metabolic disorders;
  • thoracotomy – an operation that involves opening the chest cavity.


By means of microbiological studies, information was obtained that aseptic inflammation arises in the cartilage damaged by costal chondritis. This is a pathology that is not accompanied by an increase in temperature, sweating and hyperemia, but is characterized by a completely asymptomatic course. This is one of the main dangers of the disease.

But despite the absence of obvious signs, the cartilage undergoes structural changes.Thus in them occurs:

  • deposition of calcium salts;
  • metaplastic and hyperplastic phenomena;
  • degeneration, accompanied by the formation of vacuoles;
  • alteration of bone septa;
  • the introduction of cartilage into bone tissue.

Signs of the disease

It is very important to know exactly what the symptoms of Tietze syndrome look like. Treatment of pathology is carried out, regardless of clinical manifestations, but such information will help to respond in time to alarming signs and consult a doctor.It is not for nothing that the timeliness of diagnosis is rightly considered a guarantee of the effectiveness of further therapy.

There are several main symptoms of costal chondritis by which one can suspect the presence of this disease in the body.

  • Acute painful sensations in the lower and left chest of a pseudo-angular nature, masquerading as heart pains.
  • A few hours or a day after the onset of pain, a swelling may form over the injured rib, giving pain on palpation.
  • When inhaling, the pain increases significantly, just like with coughing, chest mobility and palpation of the costal junction with the sternum.
  • Irradiation of unpleasant sensations to the area of ​​the neck, shoulder blades, collarbone and arms is quite probable. This phenomenon is caused by damage to the intercostal nerve, which is optional and does not always accompany the pathology.

The main symptom of the disease, which should alert the patient, is chest pain with a deep breath.It is this symptom that should be the reason for an early visit to the doctor.

Diagnosis of the disease

The main method for detecting costal chondritis is radiography. With its help, you can find the following picture:

  • clavate form of the injured rib, which appeared against the background of periostitis;
  • its hyperplasia – an increase in parameters compared to healthy ribs;
  • asymmetric calcification zones on the surface of the bone bases;
  • Visualization of the sternocostal joints as light spots and thickening due to ongoing degenerative processes – usually, healthy cartilage does not show itself in any way on x-ray.

If suspicious symptoms are detected in the image, often observed in the early stages of the development of Titze’s syndrome, it is advisable to undergo computed tomography or magnetic resonance imaging, which allows you to clearly visualize even the initial manifestations of pathology.

An electrocardiogram and laboratory tests are necessary to exclude more dangerous heart and respiratory defects. Such differential diagnosis is very important, because a similar symptomatology is an invariable component of all pathological processes occurring in the thoracic region.

What diseases can be confused with the syndrome

First of all, a specialist must exclude diseases of the respiratory system and cardiovascular system. Then differential diagnosis is carried out with pathologies giving similar signs:

  • rib arthritis;
  • osteochondritis;
  • costal exostosis;
  • osteomyelitis;
  • post-traumatic callus that forms in the area of ​​rib fracture.

Treatment of Tietze’s syndrome

The symptoms of costal chondritis often frighten patients with their pronounced severity.However, in fact, this disease does not pose a great danger and is treated, as a rule, with the help of conservative methods. When the first signs of pathology appear, a mandatory mode of limiting physical activity on the damaged area is introduced.

The main principle of treatment is eriotropic: in order to stop pain in the chest in the middle and on the left side, you simply need to get rid of the main provoking factors. We are talking about exhausting exercises, frequent colds, physical exertion associated with professional and domestic activities, addictions in the form of addiction to drugs, alcohol and tobacco, malnutrition and imbalance in nutrition.

If the patient has chest pain with deep inspiration and movement, symptomatic therapy is necessary. Pain syndrome is eliminated with the help of:

  • non-steroidal anti-inflammatory drugs;
  • local blockade anesthesia;
  • iodine drugs and salicylates.

The blockade involves the use of a 0.5% solution of novocaine and hydrocortisone. A total of 4-5 such injections for pain are allowed.

Iodine preparations are allowed to be used only in minimal dosages.Probably combining them with salicylates taken orally.

As for anti-inflammatory medicines, they can be used in the form of tablets and injections. Various gels and ointments of the same spectrum of action also help with pain.


Patients benefit from the treatment of costal chondritis using a weak current, X-ray and ultrasound radiation, and dry heat. Doctors often recommend the following physiotherapeutic procedures to patients:

  • UHF;
  • acupuncture;
  • electrophoresis using potassium iodide;
  • X-ray therapy;
  • Applying ozokerite and hot paraffin to damaged areas.

Beneficial effect on the affected ribs climatic treatment:

  • Sunburn in the morning;
  • sailing at sea;
  • walks on the beach and in the forest.

Therapeutic gymnastics

You can quickly get rid of annoying pain when inhaling and other unpleasant symptoms with the help of daily physical education. Such exercises are designed specifically for the thoracic region and are based on movements that do not load the joints, but at the same time affect them.

Respiratory exercise is extremely useful, which must be performed in parallel with ordinary gymnastics. At the same time, it is very important to correctly adjust the breathing by connecting the abdominal and pectoral muscles to the process.

To stabilize the tone of the breast tissue and eliminate the symptoms of costal chondritis, static exercises are recommended, which are required for deep muscle relaxation. The patient should check with a specialist about the rules for conducting therapeutic exercises.


The need for surgery in Tietze’s syndrome is extremely rare.The indications for surgical intervention are:

  • regular rib fractures;
  • no result from the use of conservative methods;
  • chronic form of pathology.

In the presence of such conditions, the patient can be assigned to resection of the cartilaginous periosteum at the site of attachment of the ribs to the spine.

Home therapy

It is worth saying that the pathological process taking place in the ribs is simply impossible to eliminate with the help of folk recipes.External compresses and ointments are also ineffective for this disease. Indeed, the beneficial elements contained in such funds simply will not reach the affected cartilage and receptors. In addition, applying a hot compress to the left chest area is prohibited.

But it is still possible to minimize the pain that occurs with costal chondritis with the help of folk remedies. Suitable for this purpose:

  • mummy solution in milk or water;
  • Herbs with soothing and analgesic properties – mint, lemon balm, chamomile, oregano, calendula;
  • Warm herbal baths with lavender, fir or eucalyptus oil.


Costal chondritis, as a rule, responds well to therapy and does not pose a serious danger to health and even more so to the patient’s life. That is why the prognosis for this pathology is almost always favorable. With appropriate treatment, elimination of harmful factors, the pathological process in the damaged ribs stops. But the already existing bone deformities are irreversible.

Tietze’s syndrome is quite capable of relapsing even after decades.So patients who have once been diagnosed with this disease should be systematically examined.



The most frequent manifestation of PE is

sudden development of dyspnea (80-92%), hymen-

rhythmic chest pain develops in 44% of cases,

and a feeling of pressure behind the sternum occurs

in 16% of cases [8].

Pericarditis, myocarditis, cardiac tamponade.

With pericarditis, the pain can be pleurisy

in nature: it increases with coughing, deep

breathing, which is associated with the involvement of the pleura

in the inflammatory process. Often with pericardium,

those pain changes with a change in posture: intensification –

– in the lying position on the left side and decreases –

in a sitting position with an inclination forward and

in a position on the right side. The pain can be

pulsating with localization in the heart

and left shoulder; irradiation is characteristic of the lateral

sections of the chest, left / right arms,

ki, neck.The pains develop gradually over the course of a few hours

, not so suddenly as with

angina pectoris, the duration of pain episodes

varies. The development of pericarditis can be accompanied by syncope and pre-syncope

states, as well as dyspnea.

Ana –

mnestic indications of the following conditions –

– testify in favor of pericarditis: autoimmune diseases, infectious diseases,

diseases, acute myocardial infarction,

uremia, myxedema, trauma, operations on the open heart

, oncological diseases, radio-

therapy, taking medications (procainamide, gid-

ralazine).Examination reveals an increase in body temperature

, tachycardia; with auscultation of the heart, a pericardial noise can be heard. For the development of cardiac tamponade

, the following objective signs are characteristic:

severe hypotension, tachycardia, dilatation –

jugular veins, during auscultation, heart sounds are muffled, decrease in pulse pressure –

, paradoxical pulse.

On the roentgenogram, in the presence of effusion in the pericardial cavity

, enlargement

of the shadow of the heart can be detected.According to the results of echocardiography

, it is also possible to detect an effusion into the cavity of the ne-

ricardium. The ECG reveals the elevation of the

ST segment of the saddle shape and the depression of the PR

segment in almost all leads, with the exception of

lead aVR, where depression

of the ST segment is recorded, and the PR shift above the isoline

(in 10 –20% of cases, there are no changes), with tampon

nad, a decrease in the amplitude of the tooth is recorded –

ca R and an electrical alternation of the ventricle –

complex.When myocarditis reveals

various disturbances of rhythm and conduction,

as well as some infarct-like changes –


Pneumothorax. The incidence, according to statistics,

ke Great Britain, 24 cases per 100 thousand per year –

lesions per year for men and for women – 9.8 cases –

tea per 100 thousand population per year [13].

The risk factors for the development of spontaneous pneumonia

motorrax include: smoking, young age,

high growth [13].Chronic obstructive

lung diseases, asthma, pulmonary fibrosis, pneumonia

monia, lung cancer, cystic fibrosis, tuberculosis,

lung damage in patients with HIV infection

are risk factors for the development of secondary pneumothorax

[13] … The cause of a tense

pneumothorax is most often an injury.

The disease is manifested by a sudden onset of stitching, sharp pains, a feeling of tightness

on the lateral surfaces of the chest.

The onset of pain is often accompanied by shortness of breath,

, cough.

On examination reveal: cyanosis, hypotension,

tachycardia, tachypnea, unilateral decrease

amplitude of chest excursions, weakened –

lazy breathing, tympanic tone with percussion –

from the side of the lesion

cervical veins

. Additional muscles can participate in respiration. Displacement of the mediastinal organs from

relative to the midline to the side, opposite to

positive to the affected part of the lung, is

a characteristic sign of tense pneumo-

thorax; in the most severe cases, there are

signs of shock.

Diagnostics is based on the data of X-ray –

but logical examination of the lungs (sensitivity –

80%). In the absence of sufficient

data to confirm or refute the

diagnosis, a computed tomography

is indicated.

Rupture of the esophagus. Chest pain, usually after

after vomiting. Examination reveals hypotension,

tachycardia, severe sweating, fever –

ku, subcutaneous emphysema, tenderness at

palpation of the abdomen in the epigastric region.

On a chest x-ray, it is possible to show pneumothorax, accumulation of air in the environment,

sthenia (pneumomediastinum), fluid in the pleus

of the ral cavity, fluid level in the mediastinum.

The presence of ACS symptoms, exfoliating –

aortic aneurysm, cardiac tamponade,

pneumothorax, PE and esophageal rupture is a reason for hospitalization. Patients

with chest pain characteristic of the listed diseases

should be hospitalized urgently if 48 hours have not passed since the last

pain episode [14].If the history pressure

exceeds 48 hours, but does not reach

2 weeks, the patient should be examined on a daily basis


The child complains of chest pain, the child complains of chest pain.

Causes of chest pain in a child

If your child complains of chest pain, pay special attention to it. It is very important to determine the exact location of the pain sensation. To determine the cause of chest pain in a child, observe him and find out how movements affect the nature of the pain, whether pain manifests itself during sleep or after eating, the child may have signs of bronchial asthma.

There are several types of chest pain, which can be caused by various reasons.

This pain usually appears after eating or after physical exertion. It is noted in the lower part of the chest, usually on one side only. The pain appears due to the tension of the abdominal ligaments connected to the diaphragm.

How to help a child? First, calm your child down and let him rest. After a short rest, the pain will go away on its own.

2. Sometimes chest pains can be psychogenic.

A child can simulate chest pain if an adult constantly complains about the symptom. But such pain cannot manifest itself during sleep or play. Long-term stress can often cause pain. In this case, the child cannot determine the exact location of the pain, since the boundaries of the sore spot are very blurred.

How to help a child? Since the cause of pain lies in the child’s psyche and has no psychological reasons, just distract him from the pain by talking or playing.

Symptoms: rash in the form of red bumps or blisters, swollen lymph nodes, fever.

How to help a child? Do not self-medicate! Call a doctor at your home. This disease is contagious, so do not allow the child to come into contact with other children, and do not go to the clinic.

4. Chest pain may appear due to bruises or inflammation in the muscles (viral myalgia).

It is quite easy to determine the focus of pain, since the pain has a clear localization and the child can indicate the sore spot himself.Pain manifests itself only when feeling the affected area.

How to help a child? Put a heating pad or woolen cloth on the sore spot, it is very important to warm the affected muscles. You can relieve severe pain with Panadol.

5. Chest pain may occur if the spine is affected.

This may be due to trauma, tuberculosis, or rheumatoid arthritis. The presence of these factors leads to a pinched nerve and chest pain.

How to help a child? To eliminate chest pains, it is necessary to treat the underlying disease that caused them.

6. Chest pain can be a sign of lung disease.

If pneumonia is complicated by inflammation of the pleura, then the child will feel acute severe pain, which will intensify when breathing and give to the shoulder. In order to identify lung disease, it is necessary to pay attention to other symptoms of pneumonia: cough, fever.

How to help a child? See a doctor immediately! If the suspicion of pleural inflammation is confirmed, the child will need hospitalization.

7. Cardiovascular disease can also cause chest pain.

As a result of the development of certain diseases such as rheumatism, tuberculosis or acute respiratory infections, pericarditis or myocarditis may occur. These inflammatory processes cause a dull aching pain in the region of the heart, but without a clear site of localization. Sometimes the pain can radiate to the shoulder or neck. The child may complain of increased pain when swallowing or vigorous breathing.

How to help a child? See your cardiologist. If the doctor finds a heart murmur and confirms the diagnosis, the child will be hospitalized.

8. Pain in the sternum often occurs when the esophagus is affected.

This can be an inflammatory process if a substance that irritates the mucous membrane has entered the esophagus, or if a foreign body is present in the esophagus (hernia, ulcer). Symptoms of a malfunction of the esophagus can be bloody vomiting, black stools, difficulty swallowing, excessive salivation, it is difficult for the child to bend forward and lie down.

How to help a child? See a doctor immediately! The child should have an endoscopic examination. Call an ambulance if symptoms worsen.

9. Trauma often leads to chest pains.

Sometimes there are no external manifestations of the injury, but when feeling the site of the injury, acute pain occurs. The pain is more pronounced with sudden movements, coughing, deep breaths. The pain has a clear localization. The bruised place becomes especially sensitive.A rib fracture can be suspected if, when pressing on the bruised area, pain occurs in the rib projection area.

How to help a child? Rib fractures heal on their own within a few weeks, but the child should still be shown to a doctor to rule out lung injury from a fractured rib.

10. Inflammation of the trachea resulting from a cold or sore throat can cause chest pain.

Symptoms of tracheitis: dry cough, fever.

How to help a child? This disease will go away in a few days. Give your child paracetamol to help relieve the illness.

11. Costochondritis (inflammation of the breast tissue) can cause chest pain.

This disease is typical for adolescents and goes away on its own.

Show the child to the doctor if:

– the child often complains of chest pain;

– cough and fever were added to chest pains;

– after a minor injury, the pain persists for more than one day and interferes with the normal activity of the child.

Call a doctor immediately if:

– the child’s breathing is difficult due to pain;

– the child constantly complains of severe chest pain, while the temperature has risen to 38.5 C;

– the child cannot take a deep breath due to pain;

– after an injury or a blow to the chest, the child complains of severe pain, but is able to move independently;

– the child has rapid breathing, there is a lack of air, while the temperature is increased.

Pain in the chest and chest area in children

Pain in the chest and chest area in a child can be observed with the following diseases:

Pleurisy, pleuropneumonia, pleural empyema . Severe stabbing pain associated with breathing, clearly localized, often accompanied by pain on palpation in the intercostal space. The pain increases with coughing and laughing, disappears with holding the breath. Typical symptoms of percussion and auscultation.

Diagnostics .X-ray follow-up.

Epidemic myalgia (Coxsackie group B viral infection, pleurodynia, Bornholm’s disease). Paroxysmal, lightning-fast, severe pain that does not depend on breathing (bloody contractions).

Diagnostics . blood picture, serological – antibodies, virus detection.

Rib disease . Precise localization of pain in the rib area (soreness when pressed).

Diagnostics .X-ray examination, blood picture, ESR.

Tietze Syndrome . In puberty, usually in girls, there are limited pains with pressure or arising spontaneously during breathing, coughing and movement, sometimes radiating to the arm, with symptoms of paresthesia. Characterized by swelling of the costal cartilage in the parasternal region, especially the II-IV ribs, on the right more often than on the left. The cause is unknown, possibly hereditary.

Diagnostics . blood picture, ESR; X-ray examination: all indicators are normal.

Pain in the chest wall without objective changes in the chest area can be caused by neuralgia associated with a disease of the spine (osteomyelitis, rheumatoid arthritis, Scheuermann’s disease, tuberculosis). Pain may precede a rash with herpes zoster. Finally, it is necessary to find out whether the pain is localized in the muscles, and also to exclude dermatomyositis and trichinosis.

Parasternal pain . Pain in the subclavian regions and between the shoulder blades is a constant symptom in diseases of the mediastinal or esophagus organs.

Diagnostics . X-ray examination.

Chest pain . Mostly observed with the onset of the flu. esophagitis, mediastinitis. Also, such pain is characteristic of thallium poisoning.

Precordial pain . Observed with myocarditis, pericarditis, lingular pleuropneumonia

Irradiating pain occurs with trauma or inflammation in the cervical spine and with functional disorders of the heart (Da Posta syndrome, Effort syndrome).

Dull prolonged pain in the heart, sometimes with a strong tingling sensation, as well as pain radiating to the left arm and shoulder, as in angina pectoris, can be caused by myo- or pancarditis due to acute expansion of the heart (viral myocarditis, rheumatic fever). If the pain is combined with a friction murmur, synchronous with heart beats, visible congestion in the veins of the neck and hepatomegaly, one should think about pericarditis (X-ray examination: characteristic configuration of the heart).

Functional disorders of the heart . Older children with severe autonomic reactions often have heart attacks, tachycardia, extrasystole, dizziness, respiratory failure (lack of air, frequent yawning). It may be associated with neuropathic hyperventilation (Da Costa’s syndrome, Effort’s syndrome).

Diagnostics . ECG normal with high T waves, significant fluctuations in blood pressure with a tendency to psychogenic hypertensive crises.

Women’s magazine www.BlackPantera.ru: G. Everbeck

More on the topic:

Pain in the chest in a child, causes, symptoms, treatment

Pain in the chest area is observed much less frequently than headache or abdominal pain.

It happens with herpes, rib fractures, pericarditis and other diseases.

Children describe their pain sensations incompletely and inaccurately. Objective examination methods play a decisive role: examination, percussion, palpation, auscultation, X-ray examination, blood test.

Herpes zoster (herpes zoster; herpes zoster) is a disease caused by the varicella-zoster virus.

Clinical picture. Disturbed by a sharp girdle pain, accompanied by the appearance on the skin of the chest along the intercostal nerves of vesicular eruptions, usually unilateral. Regional lymphadenopathy is observed. Most of the bubbles later dry up with the formation of crusts, some open and erosions form in their place.

Treatment . Paracetamol is prescribed – 10-15 mg / kg of body weight 3 times in 1 day, diclofenac sodium – 2-3 mg / (kg-day), vitamins of group B, acyclovir – 20 mg / (kg-day) orally. Locally – treatment with solutions of aniline dyes (methylene blue, brilliant green), the use of ointments with antiviral properties (tebrofen, oxolin, etc.), lotions with interferon.

Fracture of ribs usually occurs as a result of direct mechanical force or a fall.Fractures can be open and closed, single or multiple.

Clinical picture. Complaints of pain in the chest area. There is a connection with trauma; local soreness in the rib area, limited swelling, sharp pain on palpation. The diagnosis is confirmed by X-ray examination.

Treatment . Analgesics are prescribed: paracetamol – 10-15 mg / kg 3 times in 1 day, diclofenac – 2-3 mg / (kg “day). A consultation with a surgeon is shown.

Pericarditis – inflammation of the heart shirt of an infectious, allergic, immunocomplex or other genesis (for example, with diffuse connective tissue diseases, uremia, hemorrhagic diseases, tumors). The accumulation of a large volume of fluid in the pericardium leads to cardiac tamponade due to the difficulty of its diastolic expansion. In this case, the pain is of a different nature.

Clinical picture. With effusion pericarditis, pressing pain is accompanied by a forced position of the body, swelling of the cervical veins, expansion of the borders of the heart, deafness, a triangular shadow of the heart on the roentgenogram, low voltage of the teeth on the ECG.Dry pericarditis causes stabbing pains that are aggravated by deep breathing and changes in body position.

Treatment . NSAIDs are prescribed: indomethacin – 2-3 mg / (kg-day), diclofenac – 2-3 mg / (kg-day), ibuprofen – 10-15 mg / (kg-day). Treatment of the underlying disease.

The defeat of the parietal pleura is accompanied by pain in the chest wall.

Clinical picture. Sharp, stabbing pain on breathing (worse with deep inspiration, coughing).Breathing is often shallow, gentle, the cough is short, obsessive, dry.

Treatment . Paracetamol is prescribed – 10-15 mg / kg 3 times in 1 day, codeine – for children over 6 months of 0.002-0.01 g. Treatment of the underlying disease.

The optimal food for a newborn baby is breast milk.

Health from the very first days after birth strongly influences the whole future life of a new person …

When it comes to feeding, you can’t count on common sense …

The first time you see your child, you may be a little overwhelmed by the upcoming caring for him….

Most parents fall into panic, and it is not unreasonable, at the mere thought that they will have to teach their child to sleep soundly all night …

Reprinting of materials from the site is strictly prohibited!

The information on this site is provided for educational purposes and is not intended as medical advice or treatment.

Sources: http://www.vashaibolit.ru/6631-prichiny-boli-v-grudi-u-rebenka.html, http://www.blackpantera.ru/diagnostika/41535/, http: // www …sweli.ru/deti/zdorove/detskie-bolezni/bol-v-oblasti-grudnoy-kletki-u-rebenka-prichiny-simptomy-lechenie.html

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