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Inflammation of the cartilage connecting ribs to the breastbone. Causes include physical strain, prolonged vigorous coughing, and viral infections; though in many cases, no clear cause is found.
Your doctor may ask these questions to check for this disease:
This condition resolves by itself, but may take several months to fully resolve. Medications like painkillers and anti-inflammatory pills can speed up healing. Simple measures like warm compresses and decreasing physical strain can also help.
Reviewed By:
Scott Nass, MD, MPA, FAAFP, AAHIVS (Primary Care)
Dr. Nass received dual medical degrees from the David Geffen School of Medicine at UCLA and Charles R. Drew University in Medicine and Science. He completed Family Medicine residency at Ventura County Medical Center with subsequent fellowships at Ventura, University of North Carolina-Chapel Hill, George Washington University, and University of California-Irvine. He holds faculty appointments at Keck School of Medicine of USC, Loma Linda University School of Medicine, and Western University of Health Sciences.
Yoshinori Abe, MD (Internal Medicine)
Dr. Abe graduated from The University of Tokyo School of Medicine in 2015. He completed his residency at the Tokyo Metropolitan Health and Longevity Medical Center. He co-founded Ubie, Inc. in May 2017, where he currently serves as CEO & product owner at Ubie. Since December 2019, he has been a member of the Special Committee for Activation of Research in Emergency AI of the Japanese Association for Acute Medicine. | | Dr. Abe has been elected in the 2020 Forbes 30 Under 30 Asia Healthcare & Science category.
Content updated on Mar 31, 2024
Following the Medical Content Editorial Policy
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With a free 3-min Costochondritis quiz, powered by Ubie's AI and doctors, find possible causes of your symptoms.
This questionnaire is customized to your situation and symptoms, including the following personal information:
Biological Sex - helps us provide relevant suggestions for male vs. female conditions.
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Q.
Pectus Excavatum? Why Your Sternum Is Dipping & Medical Next Steps
A.
Pectus excavatum is a sunken sternum from abnormal rib cartilage growth that can be cosmetic or limit breathing and heart function; doctors assess severity with an exam and imaging like a CT Haller Index plus heart and lung tests to guide options from observation and posture work to vacuum bell or surgery such as Nuss or Ravitch. There are several factors to consider, including severity, symptoms, growth spurts, and connective tissue signs; see below for specific red flags, step by step next actions, and when to seek urgent care or a thoracic surgery referral.
References:
* Wang H, Chen Y, Sun Y, Chen C, Guo Z, Du J, Li G. Etiology, Pathophysiology, Diagnosis, and Management of Pectus Excavatum: A Comprehensive Review. J Clin Med. 2024 Jan 15;13(2):466. doi: 10.3390/jcm13020466. PMID: 38256333.
* Jürgens P, Vonderhagen S, Hülsemann M, Rabe C, Knab VM, Warkentin M, Löffler L, Strizik A, Gosemann JH, Kluth D, Metzelder ML, Funk M, Knoefel WT, Kalff JC, Scherer M. Pectus Excavatum: Current Opinions on Surgical Repair and Future Directions. Children (Basel). 2023 May 12;10(5):856. doi: 10.3390/children10050856. PMID: 37190035.
* Fonkalsrud EW. Pectus excavatum: A comprehensive review of surgical techniques, outcomes, and considerations. World J Pediatr Surg. 2022 Jul 14;5(3):107-114. doi: 10.1007/s43465-022-00632-6. PMID: 35839071.
* St Peter SD. Pectus excavatum: a primer for primary care physicians. J Pediatr Surg. 2020 Nov;55(11):2343-2346. doi: 10.1016/j.jpedsurg.2020.07.039. PMID: 32674971.
* Kelly RE Jr. Pectus Excavatum: Current Management and Future Directions. Semin Thorac Cardiovasc Surg. 2019 Spring;31(1):154-162. doi: 10.1053/j.semtcvs.2018.09.006. PMID: 30885565.
Q.
Sharp Chest Pain? Why Your Ribs Feel Like They’re Cracking & Medically-Approved Next Steps
A.
Sharp, cracking rib pain is most often from costochondritis, a musculoskeletal inflammation that is tender to touch and worse with movement or deep breaths; most cases are not dangerous and improve with rest, NSAIDs, heat or ice, posture changes, and gentle stretching. There are several factors to consider, including red flags like crushing pressure, pain spreading to the arm, jaw or neck, shortness of breath, sweating, fainting, or sudden severe pain that require emergency care. See below for how to tell costochondritis from heart pain, other possible causes, and medically approved next steps to guide what you should do next.
References:
* Hoang T, Brasington R. Costochondritis: an update on diagnosis and management. Curr Opin Rheumatol. 2023 Mar 1;35(2):100-106. doi: 10.1097/BOR.0000000000000941. PMID: 36723223.
* Wise R, Kim E. Tietze Syndrome: An Underdiagnosed Cause of Chest Pain. J Clin Rheumatol. 2021 Jul 1;27(5):e206-e209. doi: 10.1097/RHU.0000000000001426. PMID: 33507119.
* Kay M, Mindel J. Nonspecific Chest Wall Pain: A Narrative Review. J Clin Rheumatol. 2020 Sep;26(6):215-220. doi: 10.1097/RHU.0000000000001150. PMID: 31789725.
* Patil V, Singh H, Agrawal V, Kumar D, Gupta A, Sharma B, Singh D, Agrawal V. Management of Rib Fractures and Flail Chest: An Overview. Indian J Surg. 2020 Apr;82(2):166-173. doi: 10.1007/s12262-019-02058-1. Epub 2019 Dec 16. PMID: 32255959; PMCID: PMC7111267.
* Gulati M, Levy PD, Mukherjee D, Wong D, Butler J, Collins S, Dokholyan RS, Gulati R, Horton E, Jones PS, Kontos MC, Laffin LJ, Lange-Maia B, Mehta PK, Metkus T, Nanna M, Newby DE, Sharma G, Smith EE, Vranckx P, Winchester DE, Ziaeian B. Evaluation and Management of Chest Pain in the Emergency Department: A Review. JAMA. 2023 Aug 1;330(5):454-463. doi: 10.1001/jama.2023.11188. PMID: 37523171.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1Mott T, Jones G, Roman K. Costochondritis: Rapid Evidence Review. Am Fam Physician. 2021 Jul 1;104(1):73-78. PMID: 34264599.
https://www.aafp.org/pubs/afp/issues/2021/0700/p73.htmlProulx AM, Zryd TW. Costochondritis: diagnosis and treatment. Am Fam Physician. 2009 Sep 15;80(6):617-20. PMID: 19817327.
https://www.aafp.org/pubs/afp/issues/2009/0915/p617.htmlSchumann JA, Sood T, Parente JJ. Costochondritis. 2021 Jul 10. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. PMID: 30422526.
https://www.ncbi.nlm.nih.gov/books/NBK532931/Yoshiyama N, Tsuneyoshi S, Nishi JI, Ishii H. Infective costochondritis and multiple abscesses in a healthy adult. BMJ Case Rep. 2021 Jan 15;14(1):e240948. doi: 10.1136/bcr-2020-240948. PMID: 33452067; PMCID: PMC7813321.
https://casereports.bmj.com/content/14/1/e240948