Diagnosis of Costochondritis

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dr. simi paknikar
Medically Reviewed by dr. simi paknikar, MD
Last Updated on Dec 31, 2019
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Diagnosis of Costochondritis

Diagnosis of Costochondritis is made based on personal history and physical examination. No specific tests exist for Costochondritis.

Investigations are primarily aimed at ruling out the fatal causes of chest pain like angina or heart attack.

  • A chest x-ray is one of the most cost-effective investigations available to find out the cause of chest pain.
Chest X-ray: Diagnosis of Costochondritis
  • Gallium scan is a more sophisticated imaging study to check for infection. Infected areas show increased uptake of radioactive material gallium.
  • Blood tests are also of value. Increase in the white blood cell count could mean infection.
  • ECG is routinely ordered to rule out heart diseases.(4)

References:

  1. Costochondritis - (https://www.nhs.uk/conditions/costochondritis/)
  2. What Is Costochondritis? - (https://www.emedicinehealth.com/costochondritis/article_em.htm#what_is_costochondritis)
  3. Costochondritis - An Overview - (https://www.mayoclinic.org/diseases-conditions/costochondritis/symptoms-causes/syc-20371175)
  4. Costochondritis: Diagnosis and Treatment - (https://www.aafp.org/afp/2009/0915/p617.html)
  5. Prevention of Costochondritis - (https://www.healthdirect.gov.au/costochondritis)
  6. What You Need To Know About Costochondritis - (https://www.rchsd.org/health-articles/costochondritis-2/)

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I'd like to present a New Zealand manual physiotherapy view of costochondritis - because we do not find it mysterious, idiopathic or difficult to fix. One or some of the costovertebral joints [where the ribs hinge onto the spine] are jammed/frozen/hypomobile. This requires the more delicate sternocostal joints (where the ribs hinge onto the breastbone) to work excessively, just to allow breathing. So they strain, get irritated, then inflamed - and there's your costochondritis. Please note this is the ONLY explanation accounting for such a specific pain and inflammation.

Costochondritis is an intense condition of the midsection divider. Costochondritis Treatment normally includes moderate techniques, for instance, the use of ice or warmth in the impacted area as a measure to soothe the manifestations.

mak815

Anti-Inflammatory Medications Nonsteroidal anti-inflammatory medications [e.g. Motrin, Advil] help with two aspects of costochondritis.

Thank you Nithin and Simi - I think this is a succinct, useful summary for a patient or physician to follow. It is appreciated. I think it would be worthwhile adding in a few images and re-inforcing the need to rule out cardiac or aortic or pulmonary causes [ischemia / myocarditis / pericarditis / aotic dissection / Pulmonary emboli] first before making the diagnosis of costochondritis. Some rule out tests such as the ECG (already mentioned) and bloods such as troponin, D-Dimer, C reactive protein, CK would be sensible to add to the article. Best wishes and Keep up the good work. Dr Ameet Bakhai, MBBS, MD, FRCP - London, England www,heartconsultant.co.uk

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