History and exam

Key diagnostic factors

common

presence of risk factors

Risk factors include recent prolonged coughing or repetitive upper-limb movement causing microtrauma.

chest pain

Typically insidious onset, worse on movement of the chest wall especially with inspiration; usually unilateral.

chest-wall tenderness

Elicited by pressing slightly over the costochondral joints. There may also be tenderness of the sternoclavicular joint, rib, and adjacent muscle.

Other diagnostic factors

uncommon

chest-wall swelling

If swelling is present in addition to costochondritis, this is known as Tietze's syndrome.[8]

Risk factors

strong

microtrauma

A history of recent coughing or unaccustomed repetitive upper-limb movement is commonly associated with costochondritis.​[1]​

weak

female sex

There is weak evidence to suggest that costochondritis is more common in women.[5]

age >40 years

Evidence is scarce for this risk factor.​[1]​

sternotomy wound infection

Postoperative sternotomy wound infections may cause infective costochondritis.[10][11]

intravenous drug use

Haematogenous spread of organisms from intravenous drug use can cause infective costochondritis.[12][14]

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