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Costochondritis, also known as chest wall pain syndrome or costosternal syndrome, is a benign inflammation of the upper costochondral (rib to cartilage) and sternocostal (cartilage to sternum) joints. 90% of patients are affected in multiple ribs on a single side, typically at the 2nd to 5th ribs. [1]
Management of chest pain is based on the underlying cause. [1] Initial treatment often includes the medications aspirin and nitroglycerin. [1] [4] The response to treatment does not usually indicate whether the pain is heart-related. [1] When the cause is unclear, the person may be referred for further evaluation. [3]
Costochondritis is a common cause of chest pain, consisting of up to 30% of chest pain complaints in emergency departments. The pain is typically diffused with the upper costochondral or sternocostal junctions most frequently involved, unlike slipping rib syndrome, which involves the lower rib cage.
Treatment is usually via reassurance, as the pain generally resolves without any specific treatment. Precordial catch syndrome is relatively common, and children between the ages of 6 and 12 are most commonly affected. Males and females are affected equally. [1] It is less common in adults. [2] The condition has been described since at least ...
Evidence for efficacy of treatments is based on many case reports and series of small groups of patients. There are case reports that non-steroidal anti-inflammatories are effective for mild disease and that corticosteroids are effective for treatment of severe relapsing polychondritis.
Management of ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome) focuses on symptoms management, as no treatments that address the root cause of the illness are available. [ 1 ] : 29 Pacing, or regulating one's activities to avoid triggering worse symptoms, is the most common management strategy for post-exertional malaise .
The pain is exacerbated by movement and makes walking and breathing more difficult. Patients have found relief from the pain by lying still for a brief period of time. [5] The slightest movement of the rib cage causes a sharp increase in pain, which makes it difficult to breathe, although it generally passes off before any actual harm occurs.
Pain across the costal margin is most commonly caused by costochondritis. [ 6 ] The costal paradox , also known as Hoover's sign and the costal margin paradox , is a sign where the costal angle decreases upon inspiration rather than increasing, indicating chronic obstructive pulmonary disease .