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Tietze's Syndrome or Costochondritis

When patients come to me with pain in the chest and I feel swelling and they hurt when I press on ribs just to the side of the large bone in the middle of the chest, I often diagnose a usually harmless condition called Tietze's syndrome, also known as costochondritis.

Chest pain can be a sign of a heart attack, so doctors usually order an electrocardiogram, a chest X ray and several blood tests. Even if all the tests are normal, they may still hospitalize the patient because normal tests do not rule out a heart attack. Chest pain can also be caused by a pinched nerve in your back, a stomach ulcer, gall bladder disease and so forth, so it is often reassuring when a patient feels pain when a doctor presses on the ribs because the heart is inside a bony cavity and should not hurt when a doctor presses on a person's chest.

Your ribs attach to a large bone in the center of your chest in the front. To help you breathe in, your muscles raise your rib cage and to help you breathe out, they relax and let your ribs drop. Therefore, your ribs form a movable joint where they attach to your chest bone. It is common for people to get arthritis in these joints which hurts particularly when they breathe. Tietze's syndrome usually goes away in a few weeks or months with no treatment. However, your doctor may offer to block the pain with arthritis medication or a xylocaine injection into the painful joint.

Checked 4/3/14

May 30th, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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