Costochondritis is a common disease, a non-specific, non-purulent inflammation of the rib cartilage, a self-limiting disease of the junction of the rib cartilage and the sternum with unexplained, non-purulent inflammatory lesions of the rib cartilage, manifesting as limited pain with swelling. It occurs in adults aged 25 to 35 years, with a female predominance. It is also known as Tietze syndrome.
Etiology
Its etiology is unclear, and the possible causes are as follows.
1, viral infection, many cases reported a history of viral upper respiratory tract infection before the disease.
2. Chronic strain on the ligaments of the thoracic rib joints.
3, immune or endocrine abnormalities causing dystrophy of the rib cartilage.
4.Other causes may be related to tuberculosis, systemic malnutrition, acute bacterial upper respiratory tract infection, rheumatoid arthritis, thoracic rib joint subluxation, and injuries such as chest impact injury and violent cough.
Clinical manifestations
Initially, the patient feels chest pain, and a few days later a swollen, raised, dull or sharp painful mass appears in the affected rib cartilage, mostly in the 2nd to 4th rib cartilage next to the sternum, with the 2nd rib cartilage being the most common, and occasionally in the rib arch. The disease mostly affects a single rib, occasionally multiple ribs or both left and right ribs are involved at the same time.
The local pressure pain is obvious, and the pain is severe radiating to the back scapula or lateral shoulder, upper arm, and axilla, and is aggravated by deep breathing, coughing, and activity. Because the lesion is over the inner breast, the ipsilateral breast also has involvement pain, and female patients mistakenly visit the clinic for breast pain. The course of the disease may last for a few hours or days, but it can recur, often resolving spontaneously within a few months, or individually for several years.
Auxiliary examination
1.X-ray examination
Non-specific costochondritis chest X-ray can not find signs of lesions, but helps to exclude intrathoracic lesions, chest wall tuberculosis, rib osteomyelitis. Infectious costochondritis. Infectious costochondritis chest X-ray can show local soft tissue swelling and bone destruction, and can also exclude limited abscess chest, and X-ray iodine sinus imaging can also show the extent of the lesion.
2.B ultrasound
It can show the swelling of rib cartilage and observe the change of swelling by bilateral comparison, etc.
3.CT
It can show the swelling and ossification of cartilage well.
4.MRI
It can show the active inflammatory changes of bone, cartilage, synovium and bone marrow with high specificity and sensitivity.
5.Laboratory examination
Blood routine, blood phosphorus, blood calcium, blood sedimentation, alkaline phosphatase, etc.
Diagnosis
Based on medical history and clinical manifestations chest X-ray and CT examination.
Treatment
1, rib chondritis is generally only symptomatic treatment, such as taking analgesics, hot compresses, physiotherapy or local closure of Prucal trap. If the pain is severe, lidocaine 5 ml plus de-inflammatory suxone can be used for direct injection at the point of pain.
2, long-term drug treatment and pain can not be relieved, affecting the patient’s mood and work, or can not exclude local malignant tumors, can consider the implementation of rib cartilage resection.