Which patients with arthritis need to know ...

Updated 27 June 2014.

Written and reviewed by a Board Certified physician. See the Medical Review Board About.com.

Chest pain is not an uncommon symptom. If it does not have to be rare, it is disturbing to say the least. Faced with chest pain, people often think of a heart attack. But some other conditions with chest pain also. It is imperative to be evaluated immediately and determine the cause.

In addition to heart problems, chest pain can be caused by a lung disease or gastrointestinal tract. Pain may also radiate to the chest with the disease of the cervical or thoracic spine. Musculoskeletal diseases and costochondritis Tietze's syndrome are also associated with pain in the chest wall.

Distinction between Tietze's syndrome and costochondritis

While costochondritis and Tietze syndrome are often seen as different names for the same problem, there is a feature that distinguishes them. Tietze's syndrome and costochondritis are caused by inflammation of the joints or nerves costochondral joints chondrosternal anterior chest wall. Connecting the sternum cartilage (ie breastbone), and the ends of the ribs - Both conditions are a speed of rib cartilage. However, there are local swelling with Tietze's syndrome and costochondritis without swelling.

Tietze's syndrome:

• It is less common than costochondritis
• Onset may be gradual or sudden
• Swelling generally occurs at the second or third rib cartilage
• Exacerbated the pain in the shoulder and radiates through coughing, sneezing or movement of the chest wall
• Tenderness is felt
• a website is costal cartilages involved in 70% of cases

Costochondritis:

• More often, Tietze's syndrome
• is associated with pain and tenderness of the chest wall, without swelling
• Sensitivity usually includes an area costochondral in 90% of cases
• the second to fifth costochondral junctions are often involved
• It is also known as the front wall of the syndrome, syndrome costosternal parasternal chest syndrome chondrodynia

The diagnosis of costochondritis

During a physical examination in chest pain can be reproduced by palpation of the costal cartilage is usually sufficient to make the diagnosis of costochondritis in children, adolescents and young adults. In patients over 35, patients at risk or with a history of coronary heart disease, or anyone with cardiopulmonary symptoms are usually recommended in addition to the physical examination, electrocardiogram (ECG) and chest x-rays.

Costochondritis treatment

No clinical trials for the treatment of costochondritis. Treatment focuses on pain relief. Paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs) and other pain killers are prescribed to relieve pain with costochondritis. With prescription drugs, pain management may rest, hot packs, heating pad, and avoid activities that increase pain. Physical therapy is often required, but in some cases can be a useful treatment option. Lidocaine / corticosteroid injections may be considered costochondral in the affected areas, especially when other treatment options have little or no relief, but rarely necessary.

What to expect

The time varies costochondritis. The condition usually lasts a few weeks. It can take months. Almost always costochondritis is set in the year. It is possible, though rare, to a persistent cases of chest wall have pain with costochondritis.

The Bottom Line

Patients with rheumatoid arthritis have a higher risk than the general population of heart disease. For these patients, particularly chest pain fear is natural. If you experience chest pain, should be evaluated immediately, can not be overstated.

_Sources:

_{The ABCs of rheumatic diseases. Arthritis Foundation. Thirteenth edition.
10/06/2013 retrieved.}

_{Costochondritis: diagnosis and treatment. Anne M. Proulx, DO and Teresa W. Zryd, Dr. MD American Family. 2009 September 15; 80 (6): 617-620.}