Name
COSTOCHONDRITIS
DESCRIPTION
DETAIL
CAUSES : β’ Not fully understood β’ Trauma β’ Overuse -------------------------------------------------------------------------- DIFFERENTIAL DIAGNOSIS 1. Cardiac . Coronary artery disease . Aortic aneurysm . Mitral valve prolapse . Pericarditis . Myocarditis 2. Gastrointestinal . Gastroesophageal refl ux . Peptic esophagitis . Esophageal spasm . Gastritis 3 . Musculoskeletal . Fibromyalgia . Slipping rib syndrome - involves the lower ribs . Costovertebral arthritis . Painful xiphoid syndrome . Rib trauma with swelling . Thoracic disk compression . Ankylosing spondylitis . Epidemic myalgia . Precordial catch syndrome 4 . Psychogenic . Anxiety disorder . Panic attacks . Hyperventilation 5 . Respiratory . Asthma . Pneumonia . Chronic cough . Pneumothorax 6 . Other . Herpes zoster . Spinal tumor . Metastatic cancer . Substance abuse (cocaine)LABORATORY The diagnosis of costochondritis is based on a complete and thorough history and physical examination. Laboratory exams should only be utilized if there is concern regarding other elements of the differential diagnosis. Erythrocyte sedimentation rate inconsistently elevated X-RAY CHEST - NORMAL, DONE JUST TO EXCLUDE OTHER PATHOLOGY
TYPENOTES
DRUG(S) OF CHOICE : Non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Anaprox, Naprosyn, Aleve) or diclofenac (Voltaren). Other analgesics may be used as needed. ALTERNATIVE DRUGS : Acetaminophen PATIENT MONITORING : Followup in one week PREVENTION/AVOIDANCE : Avoid activity which increases the pain POSSIBLE COMPLICATIONS : Incomplete attention to differential diagnosis or inappropriate interventions in a desire to ensure that a more life-threatening diagnosis is not missed EXPECTED COURSE/PROGNOSIS: β’ Self-limited illness, although sometimes chronic β’ Often recurs
RELATED DISEASE
Not Available Disease
DISEASE
INVESTIGATION
X-RAY CHEST P.A. VIEW( NORMAL ), COMPLETE BLOOD COUNT
[COSTOCHONDRITIS]