Costochondritis is a nonspecific, nonsuppurative inflammatory lesion of the rib cartilage that is clinically more common. The main clinical manifestation is limited pain in the rib cartilage. If the painful area is swollen, it is referred to as Tietze’s disease. 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 dystrophy of rib cartilage, so the disease is also called dystrophic rib cartilage atrophy. 4, Histological examination of rib cartilage is normal, only the development is thicker, some people also call it rib cartilage 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 the attack can be long or short, mostly disappears on its own in 3 to 4 weeks, but often recurrent, delayed for months or even years. In mild cases, only mild chest tightness does not affect normal work, but 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, and the local pressure pain is obvious, but there is no epidermal red fever sign when bacterial infection is present. 4, the disease mostly invades single rib cartilage, occasionally multiple and bilateral involvement is seen, the site of occurrence is mostly in the 2 to 4 rib cartilage next to the sternum, with the 2nd rib cartilage being the most common. 5.X-ray examination has no abnormal changes, but it can be used to exclude malignant tumor of rib cartilage and other lesions. Differential diagnosis Because of local swelling, projection and pain, it should be differentiated from rib cartilage tumor, chest wall tuberculosis, and post-fracture scab formation. Treatment 1.Treatment is mainly symptomatic with aspirin or other non-steroidal analgesic and anti-inflammatory drugs, such as ibuprofen, etc. 2.If the pain is obvious and symptomatic treatment is not good, procaine and cortisone local closure treatment can be considered, but systemic adrenocorticosteroids should be used with caution. Other treatments include physiotherapy, hot compresses, radiotherapy, anti-infection, acupuncture and other symptomatic treatments are less effective. Traditional Chinese medicine treatment such as “Fuyuan and blood circulation soup” is effective in relieving pain, but it is not effective for enlarged and thickened rib cartilage. 4, for a few non-surgical treatment is ineffective with rib cartilage enlargement and more symptoms, malignant lesions can not be ruled out, should remove the lesion of rib cartilage 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.