costochondritis

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  • Опубліковано 23 сер 2024
  • (chest wall pain syndrome, costosternal syndrome)
    A benign inflammation (not serious) of the upper costochondral (rib-cartilage) and sternocostal (cartilage-sternum) joints.
    Most patients are affected in multiple ribs on a single side, typically at the 2nd-5th ribs.
    It predominantly affects women over 40 years of age and some among adolescents.
    (Symptom)
    • Primarily, chest pain.
    • Not present with heat, erythema, or swelling of the affected area.
    • Not present with tachycardia, hypotension, radiating pain, shortness of breath, fever, nausea, or a productive cough.
    (Diseases with chest pain)
    Many disorders cause chest pain or discomfort. They may involve the cardiovascular, gastrointestinal, pulmonary, neurologic, or musculoskeletal systems.
    Common causes:
    • chest wall disorders: Involves muscle, rib, or cartilage.
    • pleural disorders
    • gastrointestinal disorders: E.g. gastroesophageal reflux disease, esophageal spasm, ulcer disease, cholelithiasis.
    • stable angina
    Immediately life threatening:
    • acute coronary syndromes: I.e. acute myocardial infarction and unstable angina.
    • thoracic aortic dissection
    • tension pneumothorax
    • esophageal rupture
    • pulmonary embolism
    (Causes)
    Not known exactly but possibly:
    • microtrauma (repetitive minor trauma)
    • repetitive coughing
    • strenuous physical activity
    • infection (in rarer cases): Mostly, caused by Actinomyces, Staphylococcus aureus, Candida albicans, and Salmonella. Rarely, caused by Escherichia coli.
    (Diagnosis)
    • Predominantly, done based on clinical examination (physical examination) including medical history
    Examples of the physical exam to see if the pain is worsened or reproduced:
    - - crowing rooster maneuver: Costochondritis with a positive test result.
    - - hooking maneuver: Slipping rib syndrome with a positive test result.
    - - scarf test (cross-body adduction test, horizontal adduction test): Sensitized acromioclavicular joint such as in osteoarthritis with a positive test result.
    • To rule other serious conditions out. Because chest pain is considered a symptom of a medical emergency.
    Differential diagnosis (to rule out for chest pain):
    • Tietze syndrome: Present with heat, erythema, or swelling of the affected area.
    • more serious cases: Present with tachycardia, hypotension, radiating pain, shortness of breath, fever, nausea, or a productive cough.
    (Treatment)
    • rest: It is considered a self-limited condition that will resolve on its own.
    • pain management
    - - manual therapy
    - - heat
    - - ice
    - - pain relievers: E.g. nonsteroidal anti-inflammatory drugs (NSAIDs).
    - - intercostal nerve blocking injection (in cases with persistent discomfort): A combination of corticosteroids and local anesthetic.
    It may be recurrent and last weeks to months, however, refractory cases can persist to over a year.

КОМЕНТАРІ • 1

  • @KM-oy5yh
    @KM-oy5yh 5 місяців тому +1

    I'm going through this Right, Now 🎉