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Costochondritis is a relatively harmless condition that causes the cartilage of the costochondral or costosternal joints to become inflamed. This condition is characterized by pain and tenderness in the chest area that can be reproduced by applying pressure to the front of the ribcage. Although doctors have not been able to determine an exact cause for costochondritis, it has been associated with rheumatoid arthritis and other inflammatory diseases and autoimmune disorders.
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A 1994 study of costochondritis conducted by Cabrini Medical Center- New York, revealed that women and Hispanics are more likely to have costochondritis then men, and accounts for up to 30 percent of the emergency room chest pain complaints in adolescents. The study proposed that the most common cause is “repeated minor trauma to the chest wall," with viral and bacterial infections, usually following surgery, being additional risk factors. Because costochondritis causes inflammation of the joints connecting the ribs, it is also associated with inflammatory diseases and autoimmune disorders. As such, the association between rheumatology and costochondritis is clear.
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Symptoms of Costochondritis include mild to severe pain in the chest area that can radiate to the shoulders, arms, and back. Coughing, sneezing, deep breathing, hiccups, laughter, and anything that may cause the chest wall to move can aggravate the symptoms. Emotional instability, anxiety, and frequent headaches can accompany costochondritis. Infectious costochondritis is characterized by redness, swelling, or pus at the surgical site.
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Diagnosis of costochondritis begins with a medical history. The doctor will look at any recent illnesses, surgery, or trauma to the chest wall to determine a cause for the chest pain. Laboratory tests and x-rays may be ordered to rule out other possible conditions such as a heart attack. A physical exam is conducted, applying pressure to the chest between the 3rd-6th ribs. If pain or tenderness is reported and there are no other underlying medical conditions, the diagnosis is costochondritis.
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Costochondritis that is not associated with an underlying cause will go away on its own without treatment. However, nonsteroidal anti-inflammatory medications (NSAIDs) are used to relieve the symptoms, along with alternating hot and cold compresses, and avoidance of strenuous activities until symptoms clear up. In cases where costochondritis is as a result of an infection, intravenous and oral antibiotics are used to treat the infection. Long term care and follow are required. In cases where costochondritis either does not respond to treatment or is associated with an underlying condition such as rheumatoid arthritis, surgical removal of the affected cartilage may be necessary.
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Costochondritis and Rheumatology
A rheumatologist is a physician who specializes in diagnosing and treating diseases and conditions affecting the immune system that lead to the inflammation of joints, muscles, tendons, and organs. Most of these conditions are incurable. “Flare ups" caused by the original condition can often trigger a re-occurrence of costochondritis symptoms as well. And while most of these conditions are incurable, it is possible to send them into remission.