Chronic Costochondritis

Clinical Characteristics

86% of patients with costochondritis exhibit a recurrent course, while 14% experience continuous symptoms 1
The American College of Cardiology suggests that diagnosis mainly relies on clinical presentation, based on physical examination findings of costochondral joint tenderness 2
Direct palpation of the affected joint to reproduce pain confirms the musculoskeletal origin 2
Laboratory tests are not useful for establishing a diagnosis, but inflammatory markers may be elevated, supporting the inflammatory nature 2

Tietze syndrome is characterized by localized inflammation of one or more costochondral joints, accompanied by musculoskeletal chest pain 3, 4, 5
Costochondritis, on the other hand, involves inflammation of one or more ribs and/or cartilages, with a potentially broader range 3, 4, 5

In patients over 35 years old, with a history of coronary artery disease or risk factors, and those with cardiac or pulmonary symptoms, an electrocardiogram should be performed, and a chest X-ray may also be necessary 2
The possibility of acute coronary syndrome is lower when chest pain decreases significantly with inspiration, supporting a musculoskeletal diagnosis 2
Imaging studies are primarily used to rule out other diagnoses or when the presentation is atypical 2