Costochondritis, Costosternal Syndrome, Parasternal Chondrodynia, Anterior Chest Wall Syndrome

  • Epidemiology
  1. Age over 40 years is more typical
  • Pathophysiology
  1. Chronic inflammation affecting the costochondral joints
  2. Idiopathic
  • Symptoms
  1. Chest Pain accentuated by respiratory movements
  2. Localized pain to the costochondral margin at ribs 2 to 5
  3. Affects more than one costochondral margin in most patients
  • Signs
  1. Costochondral margin tenderness without swelling
  2. Palpation reproduces Chest Pain
  • Differential Diagnosis
  • Imaging
  1. Consider CT Chest if neoplasm or infection-associated local destruction suspected
  2. Consider gallium scanning if infection suspected