Costochondritis is one of the common diseases of the thoracic region. The main clinical manifestations are varying degrees of soreness and distension in the affected area, aggravated by deep breathing, coughing and squeezing the chest wall or moving the affected upper limb, often with recurrent attacks. Etiology The etiology of this disease is unknown. It was first reported by Tietze in 1921 and is therefore also known as Tietze’s disease. It may be related to the following factors: 1. Most patients have a history of upper respiratory tract infection before the onset of the disease, and some scholars believe that it may be related to viral infection; 2. It may be related to injury to the ligaments of the thoracic rib joints; 3. It may be related to endocrine abnormalities that cause nutritional disorders of the rib cartilage, so the disease is also called dystrophic rib cartilage atrophy; 4. hyperplasia. Diagnostic points 1. young people with a recent history of respiratory infection; 2. local pain is the only complaint, intensified by activity, the duration of attacks can be long or short, mostly disappearing on their own in 3-4 weeks, but often recurrent, extending over months or even years. In mild cases, only mild chest tightness does not affect normal work, in severe cases, the shoulder and arm are afraid to move, or even involve the half of the body; 3, typical clinical manifestations: the involved rib cartilage is swollen and elevated, local pressure pain is obvious, but there is no epidermal red fever sign when bacterial infection; 4, the disease mostly invades single rib cartilage, occasionally see multiple and bilateral involvement, the site of occurrence is mostly in the 2-4 rib cartilage next to the sternum, with the 2nd rib cartilage is the most common; 5, the X-ray examination has no The X-ray examination has no abnormal changes, but can be used to exclude malignant tumors and other lesions of the rib cartilage. Differential diagnosis Because of local swelling, bulging and pain, it should be differentiated from rib cartilage tumor, chest wall tuberculosis, and post-fracture scab formation. Treatment 1.Treatment mainly adopts aspirin or other non-steroidal analgesic and anti-inflammatory drugs for symptomatic treatment, such as ibuprofen; 2.If pain is obvious and symptomatic treatment is poor, procaine and cortisone can be considered for local closed treatment, but systemic adrenocorticotropic hormone drugs should be used with caution; 3.Other treatments include physical therapy, heat application, radiotherapy, anti-infection, acupuncture and other symptomatic treatments are less effective. Traditional Chinese medicine treatments such as “Fuyuan and blood circulation soup” are effective in relieving pain, but are not effective for enlarged and thickened rib cartilage; 4. For a few cases where non-surgical treatment is ineffective with obvious enlarged rib cartilage and more symptoms, and where malignant lesions cannot be ruled out, the diseased rib cartilage should be removed to achieve a cure. Intraoperative considerations Only the enlarged and thickened rib cartilage should be removed, and the periosteum and other tissues of the chest wall should be preserved. Due to the multiplicity of 2-4 ribs of cartilage adjacent to the sternum and the close proximity of the enlarged and thickened rib cartilage to the sternum, care should be taken not to injure the arteries and veins in the thorax when removing the wall lesion rib cartilage.