Costocondtiris

I'm a 53 year old male in good condition, except for chronic chest wall pain on the left side for over a year.  It occurs in specific spots (under left nipple & just below clavicle).  I've been through cardiology test, gastro test, CT scans all normal, chiropractor, physical therapist, etc. - All tests negative.

An accupuncturist suggested that I have Costocondritis - but I am skeptical because I understand it to be a short term disorder and I've been suffering with increasing frequency for 18 months now.  Have been taking a lot of NSAIDs but does not seem to do much.

Does anyone know if there are definitive tests and treatmens for Costo?

[Bhupinder Kaur, MD]

Hello,

Costochondritis is an inflammation of the junctions where the upper ribs join with the cartilage that holds them to the breastbone or sternum.Usually costo chonditis is without any cause,but sometimes infections like bacterial,viral and fungal may be causing it.

Personal history and physical exam are the mainstays of diagnosis. Tests however are sometimes used to rule out other conditions that can have similar symptoms but are more dangerous, such as heart disease.These tests are blood count,x-rays,cardiac enzymes and ECG.

Apply some cold compresses and take some anti inflammatory pain reliever.If the condition improves,then it was costochondritis other wise other conditions like cardiac ,Gi or lung pathologies.Some other possibilities are anemia and thyroid diseases(hyperthyroidism),fibromyalgia, Ankylosing spondylitis and irritation of the nerves supplying the chest by buldging disc of cervical or thoracic vertebrae.

Are you a smoker?Cigarette smoking is also associated with chronic chest pain.

Pls discuss these possibilities with your doctor.

Hope I have provided you with sufficient information.In case you need any more then pls post us.

[Niffer991]

ultrasound treatment, repeated, in a physiotherapy or other clinics is also to help costo-chondritis. The only concern for me is that below the nipple? becuase that to me, although I am not a doctor, seems like the wrong place for it to occur.

I don't know but good luck

[kasbb86]

Thanks for the info Kindd.  To answer your question, no I have never smoked.  I've had a complete cardio test including angiogram - all normal.  I've also consulted with gastroenteroligist and had 2 CT scan - again all normal.

I'm trying larger doses of ibuprofen, combined with some accupuncture treatment.  Time will tell.

My understanding of Costo is that it is relativey short in duration, yet I've suffered with this for 18 months.  Have you heard of anyone having Costo for that long?

[Bhupinder Kaur, MD]

Costochondritis is an insidious inflammation of the cartilage that attaches the ribs to the breastbone generally affecting the third or fourth ribs. Costochondritis may trigger for years or a lifetime when associated with other autoimmune diseases or conditions effecting the bones like osteoporosis.

Pls check it out.Also check out the other possibilities that I have mentioned in the earlier posts.

Hope it helps.Take care and pls do keep us posted on how you are doing.

[kasbb86]

Thanks so much for your comments.  Two more questions:

Can Costochondritis be detected using x-ray or CT scans?
Also, since it is an inflammation, would blood tests show and increase white count?

Are the any other tests that can be performed to identify if or rule it out?

Thanks!