Bone protrusions above the chest can be seen in costochondritis, sternal chondritis, rib fractures and injuries to the sternoclavicular joint, and arthritis of the sternoclavicular joint. Costochondritis, or sternal chondromalacia, is mostly due to an inflammatory reaction in the sternum and rib cartilage joint area. The cause of the onset of the disease is not clear in most patients, and a few occur in patients with a history of heart surgery or open heart. Although idiopathic costochondritis is often considered to be the same as costochondritis, it is actually a specific form of costochondritis. Patients may complain of pain in front of the upper sternum, due to coronary artery disease, more pronounced in patients with a family history of cardiac disease. It may also be due to a mild or moderate joint or osteophytes of the proximal clavicle pseudarthrosis caused by an old sternoclavicular joint injury. If a rib fracture is present, a protrusion of bone around the chest may also be present.