Causes of Costochondritis

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A Brief Explanation of Costochondritis

Costochondritis is a condition of inflamed costochondral or chondrosternal joints, commonly manifesting as an identifiable point or points of tenderness on the anterior chest. While costochondritis is a relatively benign condition that resolves in a few weeks, it is important to differentiate it from more serious causes of chest pain, such as a heart attack or angina. The reason behind this is that costochondritis is relatively benign and self-limited, while coronary heart diseases are serious and require urgent medical attention. Most cases of this condition have an unknown cause, but some cases have clear causes of costochondritis, such as infection, physical strain and chest trauma.

Possible Causes

The exact cause of costochondritis is often unknown in most cases. This is the reason why it is sometimes called an idiopathic disease. However, since the underlying pathological process is inflammation, events that can induce inflammation of the costochondral cartilage can also cause costochondritis. For instance, repeated minor trauma to the chest wall, such as when a person repeatedly lifts objects, can cause this condition. Alternatively, a blow to the chest or a sudden stretch of the chest wall can also lead to this condition.

Infections can also cause costochondritis. In particular, viral upper respiratory infections may disseminate to the costochondral joints, thereby inducing an inflammatory response. Alternatively, minor repetitive trauma from the straining and coughing associated with respiratory infections may also lead to costochondritis. When a person undergoes any kind of chest surgery, bacteria can contaminate the surgical site and spread to the costochondral joints, leading to inflammation. Rarely, costochondritis may occur due to fungal infection. Both bacterial and fungal infections of the costochondral joints may also occur among people who are intravenous drug users.

Costochondritis may also be caused by systemic rheumatic or musculoskeletal diseases, such as ankylosing spondylitis, psoriatic arthritis and fibromyalgia. Recurrent costochondritis may be a symptom of fibromyalgia. Fibromyalgia often involves the upper part of the chest and is also associated with other tender spots in the body.

What Costochondritis Affects

Anatomically, costochondritis affects the cartilaginous joints that connect the breastbone or sternum to the ribs. Most of the time, only one side of the sternum is affected, and the second to the fifth costochondral cartilages are involved. The most common finding that helps doctors diagnose costochondritis is the presence of localized pain and tenderness on the chest wall.

Treatment

When a person has noninfectious costochondritis, the symptoms will eventually resolve even without treatment. However, the patient may use pain relievers like nonsteroidal anti-inflammatory drugs (NSAIDs) to address the pain. When a person has infectious costochondritis, the doctor may need to give antibiotics intravenously. Surgery may be needed to clean the area, and recovery may take a long time with infectious causes of costochondritis.

References

Flowers, Lynn K. “Costochondritis”, https://emedicine.medscape.com/article/808554-overview

MayoClinic.com. “Costochondritis: Causes”, https://www.mayoclinic.com/health/costochondritis/DS00626/DSECTION=causes

Shiel, Michael, Jr. “Costochondritis”, https://www.emedicinehealth.com/costochondritis/page9_em.htm#Outlook

Stöppler, Melissa Conrad. “Costochondritis”, https://www.emedicinehealth.com/costochondritis/page2_em.htm