Costochondritis is more common in those between 20 and 50 years of age, though it tends to peak in the 40's. It is also more common following an infection of the upper respiratory tract, usually caused by viruses. If you suffer with fibromyalgia, you are also more likely to have this condition.
The symptoms of costochondritis include:
The most affected ribs are usually the 2nd to the 7th ribs here, in any other or combination.
Only some of the above symptoms may be present. The likelihood of this diagnosis is more important if any of the associated causes discussed below is present.
The exact cause of costochondiritis is unknown. What we do know is that if often follows:
It could also occur "out of the blue" without any warning or predisposing factor.
The diagnosis of costochondritis is often made on clinical grounds. This means that you do not actually need any specific test to make of diagnosis of this condition.
After a thorough history to see if a cause or predisposing factor can be identified, a physical examination is necessary.
The most important findings on physical examination will be reproduction of pain on the chest wall or upper abdomen by apply pressure on the ribs.
It is important that other causes of chest or upper abdominal pain be excluded as the cause of the pain by carrying out some tests. Commonly requested tests that may be requested in the diagnostic work up for costochondritis will include:
A blood test for Cardiac enzymes (like troponin) may also be done to exclude a heart attack.
Other things to look out for in a chest radiogram is the possibility of a pneumothorax - air in the chest wall, outside the lungs.
Other test that may be done in specialized center include MRI, gallium radionuclide, and ultrasound scanning.
Costochondritis resolves on its own most times without treatment. On the average, it takes 4 to 6 weeks for symptoms to resolve, but could last for several months especially in post surgical cases.
In severe cases however, the use of simple pain killers like paracetamol (acetaminophen) on it own or in conjunction with medications like ibuprofen or diclofenac (NSAIDS), helps. Steroids like prednisolone and other rheumatological medications like sulfasalazine has been found to shorten the duration of symptoms. Such medications are best prescribed by expert rheumatologist.
In the presence of fibromyalgia, adequate sleep, brisk exercise, as well as the use of antidepressants like amitriptylline or duloxetine for prolonged costochondritis pain has been found to be very helpful to some.
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