Diagnosis of Costochondritis
Diagnosis of costochondritis is based primarily on clinical evaluation, as there are no specific laboratory or imaging tests that can definitively confirm the condition. Since costochondritis shares symptoms with more serious causes of chest pain—such as heart attacks, pulmonary embolisms, or gastrointestinal issues—doctors must carefully rule out life-threatening conditions before settling on this diagnosis.
Medical History
The diagnostic process begins with a thorough discussion of symptoms:
Onset and nature of the chest pain
Triggers, such as physical activity, coughing, or breathing deeply
Duration and whether the pain improves or worsens with rest
Any recent trauma, infection, or repetitive strain
Patients may also be asked about their medical history, including risk factors for heart disease, respiratory conditions, and inflammatory disorders.
Physical Examination | Diagnosis of Costochondritis
A key diagnostic feature of costochondritis is reproducible chest pain. During examination, the doctor will:
Press on the chest wall at the costosternal joints
Assess for tenderness and inflammation
Observe the patient’s breathing and chest movement
Check for signs of swelling (though rare in costochondritis)
Pain that worsens with palpation of the rib junctions is a strong indicator of costochondritis.
Exclusion of Other Conditions
Because chest pain can signify serious issues, further tests may be conducted to rule out cardiac, respiratory, or gastrointestinal conditions:
Electrocardiogram (ECG) to rule out heart attack
Chest X-ray to assess lung or bone abnormalities
Blood tests if an infection or inflammation is suspected
Stress tests or echocardiograms, particularly in older adults or those with cardiac risk factors
If tests are normal and the pain is localised and reproducible, a diagnosis of costochondritis is usually confirmed.
Distinguishing from Tietze Syndrome | Diagnosis of Costochondritis
Tietze syndrome is a similar condition but includes visible swelling over the rib joints and typically affects younger individuals. Unlike costochondritis, Tietze syndrome is less common and more inflammatory in nature.
In conclusion, diagnosis of costochondritis involves recognising characteristic symptoms and ruling out more dangerous conditions. A careful physical examination is key to confirming this often-misunderstood cause of chest pain.
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