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  • • Painful, nonsuppurative inflammation of costochondral cartilage

    • Unknown cause

    • May represent seronegative rheumatic disease

    • Often self-limited

    • Unilateral or bilateral

    • Involves second-fourth costal cartilages

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Symptoms and Signs

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  • • Local swelling, tenderness in parasternal area

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Imaging Findings

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  • Bone scan: Can localize inflamed costochondral junctions

    Chest CT: Can localize, but less sensitive than bone scan

    Transthoracic echocardiography: May demonstrate pathologic cartilage hyperechogenicity

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Rule Out

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  • • Costochondral neoplasm: if symptoms last longer than 3 wks

    • Breast pain/causes

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  • • Physical exam

    • Consider chest CT or bone scan; usually not needed

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  • • If symptomatic, NSAIDs, local or systemic corticosteroids

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Surgery

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Indications

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  • • If symptoms longer than 3 wks and mass is present, consider neoplasm and excise

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References

Jensen S. Musculoskeletal causes of chest pain. Australian Family Physician 2001;30:834.  [PubMed: 11676310]

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