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11/10/2011 07:18 AM

Collection Facts/Opinions

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I will post some info in this thread...I may not necessarily agree with all that is said...but I am posting what is out I will be looking for opposing everyone can read both sides of the tracks - so to say...and make more informed decisions...



11/10/2011 07:26 AM
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Malvern Road Medical Centre

20 Malvern Road Glenwood NSW 2768

"Fact Sheet

Costochondritis – Tietze's Snydrome

What is Costochondritis?

Costochondritis is a condition that causes chest pain due to inflammation of the cartilage and bones in the chest wall. Also called Tietze's Syndrome, costochondritis occurs when there is inflammation of the cartilage at the junction of the rib bone and breastbone (sternum). Depending on the extent of the inflammation, costochondritis can be quite painful.

What is it like?

Most patients with costochondritis experience pain over the front of the chest (the area of the sternum). Costochondritis should only be diagnosed after excluding other more serious problems such as heart disease. Costochondritis pain is usually worsened by activity or exercise. Often the pain is worsened when taking a deep breath due to stretches of the inflamed cartilage. Pressing on the area can be extremely painful for the patient. Because of the many nerves that branch away from the chest, pain may be experienced in the shoulder or arms as well. When called Tietze's Syndrome, the pain from costochondritis is accompanied by redness and or swelling in the areas most tender.

What causes Costochondritis?

It is often difficult to indentify a single cause of costochondritis. This condition is thought to be most commonly due to repetitive microtrauma, or overuse. The most frequently affected age group is young adults between 20 and 40 years old. Costochondritis can also been found as an overuse injury in athletes, especially in competitive rowers. Costochondritis can also be found after a traumatic injury. For example, a car accident where the driver's chest strikes the steering wheel. Viral infections, usually upper respiratory infections, have also been identified as a cause of costochondritis.

What are the treatments?

Costochondritis usually responds well to simple treatment measures:


In order to decrease the inflammation, you will have to avoid activities that cause pain and exacerbation of the costochondritis. Exercise, deep breathing, and strain on the muscles of the chest may worsen the symptoms of pain and slow the healing process. As a general rule of thumb, avoid or limit activities that worsen the symptoms.

Heat Applications

Applying hot packs to the chest can be helpful in relieving symptoms of costochondritis. Apply heat several times each day, especially before activities that may irritate your symptoms. While ice application can hep with most conditions of inflammation, applying ice to the chest can be quite uncomfortable. Anti-Inflammatory Medications Non steroidal anti-inflammatories help decrease symptoms of pain making patients more comfortable. They can help to decrease inflammation, which is the root cause of the problem. Check with your doctor before taking anti-inflammatory as they have potential side effects.

See Your Doctor

While these symptoms usually improve within a few weeks, and resolve completely within a few months, there are patients in whom this problem persists for some time. See your doctor to ensure nothing more serious is going on. Occasionally, costochondritis* will be treated with cortisone injections, but this must be discussed with your doctor.

Will the symptoms return?

Most of the time, the pain associated with costochondritis significantly improves within the first 4-8 weeks. While some pain may persist, it is usually mild and only associated with strenuous activity. All symptoms of pain should resolve within six months. Costochondritis may return, but it is unlikely to do so. Having the condition once does not increase your chances of experiencing the symptoms again."

* Personal note...I am generally against steroid injections, as they are only a temporary well as steroids can reactivate dormant viruses...and if there are certain underlying conditions that are unknown, steroids in some cases can stimulate bacterial replication...


11/10/2011 07:34 AM
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(Tietze's Syndrome)

Pronounced: COST-o-kon-DRY-tis

by Ricker Polsdorfer, MD


Costochondritis is a localized pain in the anterior (front) chest wall.

Occurring in patients of any age, costochondritis means pain at the junction of the bony and cartilaginous parts of a rib—usually the second, third, fourth, or fifth rib—that is highly localized. Sometimes, but not always, there is accompanying swelling and inflammation, a condition preferably referred to as Tietze's syndrome. Neither costochondritis nor Tietze's syndrome is a serious disease, but their symptoms mimic those of several dangerous conditions.


There is no known specific cause, but several types of arthritis may affect the costochondral joints.

Risk Factors

The following factors increase your chance of developing costochondritis. If you have any of these risk factors, tell your doctor:

Rheumatoid arthritis

Ankylosing spondylitis

Reiter's syndrome


If you experience any of these symptoms, do not assume it is due to costochondritis. These symptoms may be caused by other, serious health conditions such as heart attack, digestive problems, and bone cancer. If you experience any one of them, see your physician. Sharp, localized anterior chest pain, possibly radiating to the arm or shoulder and possibly aggravated by sneezing, coughing, deep breathing, or twisting motions of the chest Tenderness or swelling over a costochondral joint (located on each rib, 1-2 inches on either side of the breast bone)


Your doctor will ask about your symptoms and medical history, and perform a physical exam. If the diagnosis is in doubt, tests to examine the ribs more closely and to rule out other conditions may include the following:

Chest x-ray —a test that uses radiation to take pictures of the chest

Blood tests

Electrocardiogram (ECG,EKG) —a test that records the heart's activity by measuring electrical currents through the heart muscle to evaluate the heart

Endoscopy or contrast x-rays of the esophagus and stomach—to look for digestive diseases. In endoscopy, a thin, lighted tube is inserted down the throat to examine the digestive system.

Bone scan —to look for cancer in the bones


Talk with your doctor about the best treatment plan for you. Once the diagnosis is confirmed and no serious condition is found, treatment is optional. Treatment choices include the following:

Hot or Cold Compresses

Often thermal treatments will provide satisfactory relief until the condition resolves itself.

Over-the-Counter Analgesics

Your doctor may recommend: aspirin, acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Anaprox, Aleve).

Cortisone Injections

An injection of local anesthetic and cortisone directly into the sore joint often relieves the pain.

Intercostal Nerve Block*

Very rarely the pain is sufficiently intense and prolonged to require numbing the area with a nerve block.

If you are diagnosed with costrochondritis, follow your doctor's instructions.


Costochondritis occurs spontaneously at any age, usually without warning or identified causes. There is no way to

prevent it.


Fibromyalgia Symptoms

National Library of Medicine


Canadian Family Physician

Health Canada


Costochondritis. EBSCO Dynamed website. Available at: . Updated

July 2009. Accessed July 27, 2009.

Gilliland BC. Relapsing polychondritis and other arthritides. In: Isselbacher K, et al. Eds. Harrison's Principles of

Internal Medicine . 14th ed. New York, NY: McGraw-Hill; 1998:1055.

Last reviewed September 2011 by John C. Keel, MD

Last Updated: 9/1/2011

Page 3 of 3

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* Personal Note...this is basically what I had...I firmly believe that this is a safer option...hurts like hell tho...

11/10/2011 07:38 AM
Posts: 6931
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Here is an interesting one....My 12 year old was DX'd with costo 2 years ago...Cardiologist tried to tell us its like a growing pain....Our PCP laughed and said she was not impressed with that doc...


: Chest Pain in Children: Not Like Adults

DEAR DR.PAUL: My 10-year old son has complained several times about "his heart hurting." When I question him about the location of the pain, it is in his breastbone. He does not have difficulty breathing and has no history of heart problems. Is there anything that I can do for him such as giving him Tylenol or Advil?

DR.PAUL ANSWERS: : This is an example of how kids are so different from adults. If an adult complains of chest pain, it is considered a medical emergency fearing that this is a heart attack. Fortunately in children, this is not the case. As a matter of fact, heart attacks and other cardiac problems are extremely rare in kids. Reassuringly, one study performed in children with chest pain confirmed that in almost all cases both the chest x-ray and Electrocardiogram(ECG) were normal. The most common cause of chest pain in children is "Chest Wall Pain". In other words pain related to the actual ribs or muscles and not the lungs or heart.

Usually the history and description of symptoms is an important clue to differentiating chest wall pain from pain of cardiac or heart origin. Cardiac pain is usually a feeling of chest tightness or heaviness, with really no specific location. In addition, cardiac pain may radiate to the arms or jaw and is frequently associated with nausea, dizziness or excessive sweating. Heart pain also does not change with respiratory movements or body movements. However, chest wall pain, is made worse or brought on by chest movements such as taking a deep breath or moving around. Also, in contrast to heart pain, chest wall pain is very specific in location. The child usually points exactly to where it hurts and a doctor can actually cause the pain when touching the tender area of the chest.

What is the cause of chest wall pain? An obvious cause is a recent injury or trauma. Most children with repeated episodes of chest pain, have no history of injury. Although the exact cause is not understood, a common cause of chest wall condition is called "Costochondritis" which usually occurs in pre-adolescents and teenagers; I can't help to think that it is related in some way to puberty. Costochondritis is an inflammation of the joint between the breast bone(sternum) and the ribs. In younger children this "costochondral" area is soft or cartilaginous. With puberty and growth, this soft area calcifies making it harder and for some reason, this area becomes irritated resulting in pain and tenderness. When examining children with costochondritis, we can very specifically cause pain by pressing on the "costochondral' junction, where the ribs meet the breast bone. There is no specific treatment for costochondritis, except for acetaminophen(Tylenol) as needed. Rarely, especially in girls, this can become a chronic problem called Teitze syndrome, which may need anti-inflammatory medications for a few weeks or more. However in most children the pain is intermittent and eventually goes away. Upon a usual normal medical evaluation, reassuring the child and parents that this is not a heart attack, is probably the best treatment approach as this alleviates the anxiety.


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