Costochondritis

Costochondritis is an inflammation of cartilage and bones of the chest wall which causes a chest pain. It occurs at the junction of the breast bone and the rib bone. There is a cartilage at the junction of these bones which becomes irritated and inflamed. Costochondritis can be quite painful depending on the extent of inflammation.

Cause
Costochondritis has no definite cause. Viral respiratory infections or repeated minor trauma may cause chest pains due to costochondritis. It is supposed to occur in people who use IV drugs or who have had surgery in their upper chest sometime back. After surgery the cartilage becomes more sensitive and prone to infection because of reduced blood flow. Also different types of infectious disease can cause costochondritis like:

• Viral- viral respiratory infections like straining and coughing can cause costochondritis.
  
• Bacterial- as already mentioned, bacterial infections in the surgery area on chest can also cause costochondritis
  
• Fungal- Fungal infections are rare but also one of the causes.

Symptoms
The symptoms of costochondritis are pain and tenderness at the junction of the breast bone. Too much movement and deep breathing increases the pain while it gets reduced when the person is in rest and breathes softly. The pain gradually becomes severe, starting from the front of the chest and radiating to the back, abdomen, arm or shoulder. Touching the area affected by costochondritis can be very painful for the patient. The pain originates from one side of the chest but can affect both the sides at the same time. It usually lasts for one and three weeks. The most common sites of pain are fourth, fifth and sixth ribs. There is visible redness, swelling, or pus discharge at the site of surgery. It is relatively a harmless condition that usually goes away without treatment.

Diagnosis
Assessing the nature of symptoms of costochondritis, a diagnosis can be made. It is based upon the pain on gently pressing the affected joints. Diagnosis can also be made on other causes. Sometimes tests like a chest x-ray, an electrocardiogram or a blood test are done to rule out other more serious conditions. Children and adolescents may be affected by costochondritis, the peak age being ten years to twenty four years. Adults who have chest pain can also be diagnosed to have costochondritis. In adults, chest pain is considered to be a serious heart problem. It is prevalent in athletes. People, who have recovered from a car accident where the driving wheel strikes the chest, can cause costochondritis by injuring the rib cage. If tests prove normal and the physical exams are consistent with costochondritis, you will be diagnosed with costochondritis.

Tietze syndrome is often referred to as costochondritis but there is a difference:
a) Tietze is abrupt with chest pain that radiates to the arms and shoulders and lasts for several weeks.
b) Tietze syndrome shows swelling at the second and third ribs. The swelling lasts for several months.

Treatment and Prevention
The main treatment of costochondritis includes, reducing inflammation to control the pain. The basic treatment that are given in this situation are complete rest and avoiding strenuous works, applying heat packs or ice packs on the affected area and taking anti inflammatory and pain relieving medicines. Anti inflammatory non steroidal drugs like flurbiprofen, mefenamic acid, ketoprofen and naproxen are recommended for these cases.

Sometimes, if the pain is severe, a steroidal medicine is injected to the patient to help reduce pain and inflammation. Infectious costochondritis are treated with IV antibiotics. In extreme cases, when the patients fail to respond to all these, a surgery is done to remove the inflamed cartilage. Avoidance of activities that may cause strain or trauma to the rib-cage or modifying improper posture at home may serve as preventive measures against costochondritis.