Kostochondryt – Epidemiologia

Kostochondryt
Epidemiologia

Kostochondryt jest istotną przyczyną bólu w klatce piersiowej, stanowiącą od 4% do 50% przypadków w zależności od populacji i miejsca opieki. W środowisku ambulatoryjnym mięśniowo-szkieletowe przyczyny bólu klatki piersiowej dotyczą 33-47% pacjentów, natomiast w oddziałach ratunkowych kostochondryt odpowiada za około 30% przypadków. W podstawowej opiece zdrowotnej odsetek ten wynosi 13-36%. Schorzenie najczęściej dotyka osoby w wieku 40-50 lat, z przewagą kobiet (69% w jednym z badań). U dzieci i młodzieży kostochondryt stanowi 10-31% przypadków bólu w klatce piersiowej, z częstością około 4%. Czynniki ryzyka obejmują powtarzalne ruchy kończyn górnych, alergie środowiskowe, sporty kontaktowe oraz niedobór witaminy D, który jest szczególnie istotny u dzieci. Kostochondryt jest diagnozą kliniczną opartą na wykluczeniu, z brakiem specyficznych badań diagnostycznych i ograniczonym nadzorem epidemiologicznym.

<a href="#epidemiologia-kostochondrytu”>Epidemiologia kostochondrytu

Częstotliwość kostochondrytu w różnych warunkach klinicznych
Rozkłady demograficzne
Kostochondryt u dzieci i młodzieży

Nadzór nad kostochondrytem

Czynniki ryzyka i profilaktyka
Rzadkie postaci kostochondrytu
Czas trwania schorzenia
Wyzwania diagnostyczne i nadzorcze
Kolejne rozdziały

kostochondrytu”>Epidemiologia kostochondrytu

Kostochondryt jest częstą przyczyną bólu w klatce piersiowej, chociaż dokładna epidemiologia nie została dobrze ustalona. Szacuje się, że schorzenie to występuje u 4% do 50% pacjentów z bólem w klatce piersiowej, w zależności od badanej populacji i miejsca badania.¹² W środowisku ambulatoryjnym, około 33% do 47% pacjentów z bólem w klatce piersiowej ma przyczynę mięśniowo-szkieletową.³

Częstotliwość kostochondrytu w różnych warunkach klinicznych

Kostochondryt odpowiada za znaczącą część wizyt związanych z bólem w klatce piersiowej zarówno w podstawowej opiece zdrowotnej, jak i w warunkach szpitalnych:

W szpitalnych oddziałach ratunkowych kostochondryt stanowi około 30% przypadków bólu w klatce piersiowej.⁴⁵⁶
W podstawowej opiece zdrowotnej kostochondryt odpowiada za 13% do 36% przypadków ostrego bólu w klatce piersiowej.⁷⁸
Ogólnie, bóle mięśniowo-szkieletowe w klatce piersiowej stanowią 15% do 45% przypadków bólu w klatce piersiowej o pochodzeniu niesercowym w oddziałach ratunkowych.⁹

Meta-analiza obejmująca 15 000 wizyt na oddziałach ratunkowych wykazała, że 16% pacjentów cierpiało na ból w klatce piersiowej pochodzenia mięśniowo-szkieletowego.¹⁰ W innym badaniu stwierdzono, że 45% z 1 300 wizyt na oddziałach ratunkowych z powodu bólu w klatce piersiowej miało przyczynę mięśniowo-szkieletową.¹¹

Istnieje wyraźna różnica w częstości występowania diagnoz mięśniowo-szkieletowych pomiędzy podstawową opieką zdrowotną a warunkami szpitalnymi. W badaniu europejskim stwierdzono wyższą częstość występowania diagnoz mięśniowo-szkieletowych u pacjentów z bólem w klatce piersiowej zgłaszających się do podstawowej opieki zdrowotnej w porównaniu z warunkami szpitalnymi (20% vs 6%).¹²

Rozkłady demograficzne

Kostochondryt najczęściej dotyka osoby dorosłe w wieku od 40 do 50 lat, co może maskować patologię sercową w tej grupie wiekowej.¹³¹⁴¹⁵ Występuje większa częstość zachorowań u kobiet niż u mężczyzn.¹⁶¹⁷¹⁸ W jednym z badań przeprowadzonych w 1994 roku wykazano, że kobiety stanowiły 69% pacjentów z kostochondrytem, podczas gdy tylko 31% w grupie kontrolnej.¹⁹²⁰

Niektóre badania sugerują również zwiększoną częstość występowania kostochondrytu w populacji latynoskiej, chociaż większość badań nie wymienia rasy jako czynnika wpływającego na częstość występowania.²¹²²²³

Kostochondryt u dzieci i młodzieży

Kostochondryt może również występować u dzieci i młodzieży. Badania dotyczące bólu w klatce piersiowej u dzieci wykazują, że kostochondryt stanowi:²⁴

10-31% wszystkich przypadków bólu w klatce piersiowej u dzieci²⁵
13-14% przypadków u młodzieży z bólem w klatce piersiowej²⁶²⁷
Ogólna częstość występowania wynosi około 4% u dzieci i młodzieży²⁸

Szczytowy wiek występowania bólu w klatce piersiowej u dzieci przypada na 12-14 lat.²⁹ W przeciwieństwie do dorosłych, dane sugerują, że u dzieci kostochondryt dotyka chłopców i dziewczynki w równym stopniu.³⁰

Nadzór nad kostochondrytem

Monitorowanie kostochondrytu jako jednostki chorobowej nie jest dobrze ustalone. Ze względu na fakt, że jest to diagnoza ustalana głównie na podstawie wywiadu i badania fizykalnego oraz że często jest to rozpoznanie wykluczające, dane nadzoru są ograniczone.³¹³²

Czynniki ryzyka i profilaktyka

Istnieją określone czynniki, które mogą zwiększać ryzyko rozwoju kostochondrytu:³³

Aktywność zawodowa lub rekreacyjna wymagająca powtarzalnych ruchów kończyn górnych i górnej części klatki piersiowej (np. u wioślarzy wyczynowych kostochondryt jest zazwyczaj obserwowany w fazie „sweep”, a pacjenci mogą odczuwać ból podczas przywiedzenia barku)³⁴
Alergie środowiskowe predysponujące do powtarzających się kichnięć lub kaszlu³⁵
Uprawianie sportów kontaktowych³⁶
Wykonywanie pracy fizycznej³⁷

Ostatnie badania wskazują również na potencjalny związek między niedoborem witaminy D a kostochondrytem, szczególnie u dzieci:³⁸

Wykazano, że stężenie witaminy D jest znacząco niższe u pacjentów z kostochondrytem w porównaniu do grupy kontrolnej³⁹
Sugeruje się, że niedobór witaminy D powinien być rozważany jako czynnik ryzyka kostochondrytu⁴⁰⁴¹

W zakresie profilaktyki, unikanie czynności nasilających objawy oraz staranne przestrzeganie prawidłowej mechaniki podczas intensywnych ćwiczeń może pomóc zapobiec wystąpieniu kostochondrytu.⁴²

Rzadkie postaci kostochondrytu

Chociaż kostochondryt sam w sobie jest stosunkowo powszechną przyczyną bólu w klatce piersiowej, istnieją rzadkie postaci związane z określonymi patogenami lub schorzeniami:

Gruźlica ściany klatki piersiowej – rzadka postać gruźlicy mięśniowo-szkieletowej, stanowiąca 1-5% wszystkich przypadków gruźlicy mięśniowo-szkieletowej. Zajęcie połączenia żebrowo-chrzęstnego jest jedną z najrzadszych form gruźlicy.⁴³
Zakażenia Salmonella – pierwotne ropnie ściany klatki piersiowej i kostochondryt spowodowane przez nietyfoidalne szczepy Salmonella są rzadkie.⁴⁴
Zespół SAPHO – należy go rozważyć u pacjentów z przewlekłym kostochondrytem, szczególnie przy utrzymywaniu się objawów i słabej odpowiedzi na leczenie NLPZ, nawet przy braku typowych zmian skórnych.⁴⁵

Częstość występowania zakażeń ran mostkowych po sternotomii pośrodkowej wynosi 0,1-1,6%, co może prowadzić do rozwoju kostochondrytu w niektórych przypadkach.⁴⁶

Czas trwania schorzenia

Kostochondryt jest zazwyczaj schorzeniem samoograniczającym się:⁴⁷

Trwa zwykle od kilku tygodni do kilku miesięcy⁴⁸
Zazwyczaj nie utrzymuje się dłużej niż rok⁴⁹
U młodzieży z kostochondrytem może wystąpić dłuższy okres objawów⁵⁰

Długotrwałe utrzymywanie się objawów (np. 7 lat) powinno być uznane za czerwoną flagę sugerującą alternatywną diagnozę, taką jak zespół SAPHO.⁵¹

Wyzwania diagnostyczne i nadzorcze

Kostochondryt pozostaje w dużej mierze diagnozą kliniczną opartą na wykluczeniu, co stanowi wyzwanie dla dokładnego nadzoru epidemiologicznego:⁵²

Diagnoza opiera się głównie na wywiadzie i badaniu fizykalnym wykazującym odtworzenie bólu przez palpację przyśrodkowej okolicy ściany klatki piersiowej⁵³
Brak jest badań klinicznych dotyczących leczenia kostochondrytu, a obecnie akceptowane podejścia terapeutyczne opierają się na dowodach niskiego poziomu lub konsensusie ekspertów⁵⁴
Niedawny systematyczny przegląd interwencji w bólu w klatce piersiowej o pochodzeniu niesercowym zidentyfikował tylko dwa randomizowane badania kliniczne (RCT) dotyczące przyczyn mięśniowo-szkieletowych⁵⁵

Te ograniczenia w diagnozowaniu i monitorowaniu kostochondrytu stanowią wyzwanie dla dokładnego określenia jego rzeczywistej częstości występowania i dystrybucji w populacji.

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Materiały źródłowe

#1 Costochondritis | Treatment & Management | Point of Care
https://www.statpearls.com/point-of-care/20071
The epidemiology of costochondritis is not well-established, though the condition is estimated to occur in 4% to 50% of patients with chest pain. […] A 1994 study showed a higher frequency of costochondritis in female patients. Costochondritis was the diagnosis in 36 cases (30%) in a group of 122 individuals presenting to the emergency department with chest pain not due to malignancy, fever, or trauma. […] Another study of noncardiac chest pain showed that 45% of 1,300 emergency room visits for chest pain had a musculoskeletal cause. […] A meta-analysis of 15,000 ER visits found that 16% of patients had musculoskeletal chest pain. […] In contrast, within the ambulatory setting, approximately 33% to 47% of patients with chest pain have a musculoskeletal origin. […] Costochondritis most commonly affects adults aged 40 to 50 years. Thus, the condition can mask cardiac pathology. Chest pain in adolescents presenting to an outpatient clinic is frequently attributed to musculoskeletal causes (31%), with costochondritis comprising 13% of the cases.
#2 Costochondritis: Practice Essentials, Pathophysiology, Etiology
https://emedicine.medscape.com/article/808554-overview
The exact prevalence of a musculoskeletal etiology for chest pain is not known, although the overall prevalence of musculoskeletal chest pain was approximately 10% in one study. In a 1994 emergency department study, 30% of patients with chest pain had costochondritis. In that study, women comprised 69% of patients with costochondritis versus 31% of patients with chest pain but without costochondritis.
#3 Costochondritis | Treatment & Management | Point of Care
https://www.statpearls.com/point-of-care/20071
The epidemiology of costochondritis is not well-established, though the condition is estimated to occur in 4% to 50% of patients with chest pain. […] A 1994 study showed a higher frequency of costochondritis in female patients. Costochondritis was the diagnosis in 36 cases (30%) in a group of 122 individuals presenting to the emergency department with chest pain not due to malignancy, fever, or trauma. […] Another study of noncardiac chest pain showed that 45% of 1,300 emergency room visits for chest pain had a musculoskeletal cause. […] A meta-analysis of 15,000 ER visits found that 16% of patients had musculoskeletal chest pain. […] In contrast, within the ambulatory setting, approximately 33% to 47% of patients with chest pain have a musculoskeletal origin. […] Costochondritis most commonly affects adults aged 40 to 50 years. Thus, the condition can mask cardiac pathology. Chest pain in adolescents presenting to an outpatient clinic is frequently attributed to musculoskeletal causes (31%), with costochondritis comprising 13% of the cases.
#4 Costochondritis: Practice Essentials, Pathophysiology, Etiology
https://emedicine.medscape.com/article/808554-overview
The exact prevalence of a musculoskeletal etiology for chest pain is not known, although the overall prevalence of musculoskeletal chest pain was approximately 10% in one study. In a 1994 emergency department study, 30% of patients with chest pain had costochondritis. In that study, women comprised 69% of patients with costochondritis versus 31% of patients with chest pain but without costochondritis.
#5 Costochondritis | SpringerLink
https://link.springer.com/chapter/10.1007/978-3-319-50512-1_36
Costochondritis accounts for 30% of chest pain visits to the emergency department and 13% of visits to primary care. […] Bsner S, Becker A, Haasenritter J, Abu Hani M, Keller H, Snnichsen AC, Karatolios K, et al. Chest pain in primary care: epidemiology and pre-work-up probabilities. Eur J Gen Pract. 2009;15:1416.
#6 Costochondritis | Enhanced Dental CPD Online
https://www.dentaljuce.com/shorts-costochondritis
Costochondritis is a common condition responsible for 1336% of acute chest pain-related concerns among adults, depending on the setting, and 1439% among adolescents. It primarily affects individuals over the age of 40 and is more common in women than men. […] Costochondritis is a common cause of chest pain in emergency departments, accounting for approximately 30% of such cases.
#7 Costochondritis: Diagnosis and Treatment | AAFP
https://www.aafp.org/pubs/afp/issues/2009/0915/p617.html
Costochondritis can affect children as well as adults. A study of chest pain in an outpatient adolescent clinic found that 31 percent of adolescents had musculoskeletal causes, with costochondritis accounting for 14 percent of adolescent patients with chest pain. […] Costochondritis is a common diagnosis in adults with acute chest pain. It is present in 13 to 36 percent of these patients, depending on the study and the patient setting. […] In a prospective study of adult patients presenting to an emergency department with chest pain, 30 percent had costochondritis. […] A prospective study of episodes of care for chest pain in a primary care office network found musculoskeletal causes in 20 percent of episodes of care, with costochondritis responsible for 13 percent. […] These data are similar to a study of patients with noncardiac chest pain that found reproducible chest wall tenderness (although not specifically defined as costochondritis) in 16 percent of patients. […] A European study found a higher prevalence of musculoskeletal diagnoses in patients with chest pain presenting in primary care settings compared with hospital settings (20 versus 6 percent, respectively).
#8 Costochondritis – Wikipedia
https://en.wikipedia.org/wiki/Costochondritis
Costochondritis is a common condition that is responsible for approximately 13-36% of acute chest pain-related concerns from adults depending on the setting, with 14-39% for adolescents. […] It is most often seen in individuals who are older than 40 years of age and occurs more often in women than in men.
#9 Costochondritis: Rapid Evidence Review | AAFP
https://www.aafp.org/pubs/afp/issues/2021/0700/p73.html
Costochondritis is a common cause of chest pain. It most commonly occurs in adults between 40 and 50 years of age, with a slight predominance in women. […] The most common age for costochondritis is middle age (between 40 and 50 years of age) with a slight predominance in women (69%) vs. men (56%). […] Approximately 1% to 3% of all ambulatory visits in the primary care setting are for chest pain.511 Of these, chest wall pain accounts for 20% to 50%.1,512 Costochondritis in particular accounts for 6% to 13%.6,10,11 […] In emergency departments, chest pain accounts for 9% to 10% of visits, with musculoskeletal causes accounting for 15% to 45% of noncardiac chest pain.1315
#10 Costochondritis | Treatment & Management | Point of Care
https://www.statpearls.com/point-of-care/20071
The epidemiology of costochondritis is not well-established, though the condition is estimated to occur in 4% to 50% of patients with chest pain. […] A 1994 study showed a higher frequency of costochondritis in female patients. Costochondritis was the diagnosis in 36 cases (30%) in a group of 122 individuals presenting to the emergency department with chest pain not due to malignancy, fever, or trauma. […] Another study of noncardiac chest pain showed that 45% of 1,300 emergency room visits for chest pain had a musculoskeletal cause. […] A meta-analysis of 15,000 ER visits found that 16% of patients had musculoskeletal chest pain. […] In contrast, within the ambulatory setting, approximately 33% to 47% of patients with chest pain have a musculoskeletal origin. […] Costochondritis most commonly affects adults aged 40 to 50 years. Thus, the condition can mask cardiac pathology. Chest pain in adolescents presenting to an outpatient clinic is frequently attributed to musculoskeletal causes (31%), with costochondritis comprising 13% of the cases.
#11 Costochondritis | Treatment & Management | Point of Care
https://www.statpearls.com/point-of-care/20071
The epidemiology of costochondritis is not well-established, though the condition is estimated to occur in 4% to 50% of patients with chest pain. […] A 1994 study showed a higher frequency of costochondritis in female patients. Costochondritis was the diagnosis in 36 cases (30%) in a group of 122 individuals presenting to the emergency department with chest pain not due to malignancy, fever, or trauma. […] Another study of noncardiac chest pain showed that 45% of 1,300 emergency room visits for chest pain had a musculoskeletal cause. […] A meta-analysis of 15,000 ER visits found that 16% of patients had musculoskeletal chest pain. […] In contrast, within the ambulatory setting, approximately 33% to 47% of patients with chest pain have a musculoskeletal origin. […] Costochondritis most commonly affects adults aged 40 to 50 years. Thus, the condition can mask cardiac pathology. Chest pain in adolescents presenting to an outpatient clinic is frequently attributed to musculoskeletal causes (31%), with costochondritis comprising 13% of the cases.
#12 Costochondritis: Diagnosis and Treatment | AAFP
https://www.aafp.org/pubs/afp/issues/2009/0915/p617.html
Costochondritis can affect children as well as adults. A study of chest pain in an outpatient adolescent clinic found that 31 percent of adolescents had musculoskeletal causes, with costochondritis accounting for 14 percent of adolescent patients with chest pain. […] Costochondritis is a common diagnosis in adults with acute chest pain. It is present in 13 to 36 percent of these patients, depending on the study and the patient setting. […] In a prospective study of adult patients presenting to an emergency department with chest pain, 30 percent had costochondritis. […] A prospective study of episodes of care for chest pain in a primary care office network found musculoskeletal causes in 20 percent of episodes of care, with costochondritis responsible for 13 percent. […] These data are similar to a study of patients with noncardiac chest pain that found reproducible chest wall tenderness (although not specifically defined as costochondritis) in 16 percent of patients. […] A European study found a higher prevalence of musculoskeletal diagnoses in patients with chest pain presenting in primary care settings compared with hospital settings (20 versus 6 percent, respectively).
#13 Costochondritis | Treatment & Management | Point of Care
https://www.statpearls.com/point-of-care/20071
The epidemiology of costochondritis is not well-established, though the condition is estimated to occur in 4% to 50% of patients with chest pain. […] A 1994 study showed a higher frequency of costochondritis in female patients. Costochondritis was the diagnosis in 36 cases (30%) in a group of 122 individuals presenting to the emergency department with chest pain not due to malignancy, fever, or trauma. […] Another study of noncardiac chest pain showed that 45% of 1,300 emergency room visits for chest pain had a musculoskeletal cause. […] A meta-analysis of 15,000 ER visits found that 16% of patients had musculoskeletal chest pain. […] In contrast, within the ambulatory setting, approximately 33% to 47% of patients with chest pain have a musculoskeletal origin. […] Costochondritis most commonly affects adults aged 40 to 50 years. Thus, the condition can mask cardiac pathology. Chest pain in adolescents presenting to an outpatient clinic is frequently attributed to musculoskeletal causes (31%), with costochondritis comprising 13% of the cases.
#14 Costochondritis: Rapid Evidence Review | AAFP
https://www.aafp.org/pubs/afp/issues/2021/0700/p73.html
Costochondritis is a common cause of chest pain. It most commonly occurs in adults between 40 and 50 years of age, with a slight predominance in women. […] The most common age for costochondritis is middle age (between 40 and 50 years of age) with a slight predominance in women (69%) vs. men (56%). […] Approximately 1% to 3% of all ambulatory visits in the primary care setting are for chest pain.511 Of these, chest wall pain accounts for 20% to 50%.1,512 Costochondritis in particular accounts for 6% to 13%.6,10,11 […] In emergency departments, chest pain accounts for 9% to 10% of visits, with musculoskeletal causes accounting for 15% to 45% of noncardiac chest pain.1315
#15 Costochondritis
https://fpnotebook.com/CV/Sx/Cstchndrts.htm
Peak Incidence age 40 to 50 years old. […] Slightly more common in women.
#16 Costochondritis: Practice Essentials, Pathophysiology, Etiology
https://emedicine.medscape.com/article/808554-overview
The exact prevalence of a musculoskeletal etiology for chest pain is not known, although the overall prevalence of musculoskeletal chest pain was approximately 10% in one study. In a 1994 emergency department study, 30% of patients with chest pain had costochondritis. In that study, women comprised 69% of patients with costochondritis versus 31% of patients with chest pain but without costochondritis.
#17 Costochondritis: Symptoms and Treatment | Doctor
https://patient.info/doctor/costochondritis-and-tietzes-syndrome
Chest pain accounts for 1-2% of consultations in primary care. In primary care, costochondritis has been found to account for 13% of presentations with chest pain. Costochondritis is more common than Tietze syndrome. Costochondritis is slightly more common in women than men and is most common between the ages of 40 and 50. Tietze syndrome can present at any age but is most common in those under the age of 40 years. Costochondritis is more common over the age of 40 years. Tietze syndrome tends to affect males and females in equal proportions. Tietze syndrome can also present as a post-traumatic condition.
#18 Costochondritis – Knowledge @ AMBOSS
https://www.amboss.com/us/knowledge/costochondritis/
Costochondritis typically occurs in individuals 40 years of age and is more common in women than in men. […] Epidemiological data refers to the US, unless otherwise specified. […] Peak incidence: 4050 years of age.
#19 Costochondritis | PM&R KnowledgeNow
https://now.aapmr.org/costochondritis/
Review of literature approximates a 10% prevalence for musculoskeletal chest pain. In a 1994 emergency department study, 30% of patients with chest pain had costochondritis. Women comprised 69% of patients with costochondritis versus 31% in the control group. […] Avoidance of aggravating activities along with careful observation of proper mechanics during strenuous activities can help prevent occurrences. For example, in competitive rowers, costochondritis is typically noted in the sweep phase, and patients may experience pain during shoulder adduction. […] Environmental allergies that predispose to repeated sneezing or coughing may increase the risk of developing costochondritis. Professional or recreational activities that require repeated movements of the upper limbs and upper thoracic cage may also increase risk.
#20 Costochondritis – Pain Spa
https://www.painspa.co.uk/condition/costochondritis/
Costochondritis can affect children as well as adults. The most common age for costochondritis is middle age (between 40 and 50 years of age) with a slight predominance in women (69%) vs. men (56%). […] Costochondritis is a common diagnosis in adults with acute chest pain. It is present in 13 to 36% of these patients, depending on the study and the patient setting. In a prospective study of adult patients presenting to an emergency department with chest pain, 30% had costochondritis.
#21 Pediatric Costochondritis: Practice Essentials, Pathophysiology, Epidemiology
https://emedicine.medscape.com/article/1006486-overview
Several studies of chest pain in pediatric patients report costochondritis prevalences of 14-32%. […] A single study reported rates as high as 79%; however, this higher prevalence may be due to less stringent diagnostic criteria for costochondritis. The overall incidence is approximately 4% in children and adolescents. […] A study indicates Hispanics may have an increased prevalence of costochondritis, but most studies do not mention race as a factor. […] Studies of chest pain in children demonstrate that males and females are affected equally. There are no recent studies evaluating the effect of gender in costochondritis. […] No data support an association between age and costochondritis; the condition is well described in children of all ages, including infants.
#22 Costochondritis: Nursing Diagnosis & Interventions | Nurse.com
https://www.nurse.com/clinical-guides/costochondritis/?srsltid=AfmBOop1zFq9XlHfW_l6P7XSaKRJFrj8lBfGfIo6QzET1GvAgzltj0IV
Costochondritis most often affects the upper costal cartilages at the 2nd to 5th ribs, and typically more than one joint is affected. […] Prevalence is not well known. However, 1994 study suggests it is more common in the Hispanic population (Disla et al., 1994).
#23 Costochondritis: What It Is, Causes, FAQs & Treatment
https://my.clevelandclinic.org/health/diseases/22167-costochondritis
Costochondritis is one of the most common causes of chest pain. Experts estimate that around one-third of people who visit a healthcare provider with chest pain or rib pain have costochondritis. […] Diagnosing costochondritis is usually a diagnosis of elimination. This means a healthcare provider might do an exam and perform tests to rule out other, more serious conditions before diagnosing costochondritis. […] Anyone can develop costochondritis, but some people have a higher risk: Athletes who play contact sports, People with physically demanding jobs, Being female, Hispanic people.
#24 Pediatric Costochondritis: Practice Essentials, Pathophysiology, Epidemiology
https://emedicine.medscape.com/article/1006486-overview
Several studies of chest pain in pediatric patients report costochondritis prevalences of 14-32%. […] A single study reported rates as high as 79%; however, this higher prevalence may be due to less stringent diagnostic criteria for costochondritis. The overall incidence is approximately 4% in children and adolescents. […] A study indicates Hispanics may have an increased prevalence of costochondritis, but most studies do not mention race as a factor. […] Studies of chest pain in children demonstrate that males and females are affected equally. There are no recent studies evaluating the effect of gender in costochondritis. […] No data support an association between age and costochondritis; the condition is well described in children of all ages, including infants.
#25 Costochondritis | 5-Minute Pediatric Consult
https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617108/all/Costochondritis?q=Escherichia+coli
Costochondritis accounts for 10-31% of all pediatric chest pain. […] Peak age for chest pain in children is 12 to 14 years. […] Frequency of sternal wound infections following median sternotomy is 0.1-1.6%.
#26 Costochondritis: Diagnosis and Treatment | AAFP
https://www.aafp.org/pubs/afp/issues/2009/0915/p617.html
Costochondritis can affect children as well as adults. A study of chest pain in an outpatient adolescent clinic found that 31 percent of adolescents had musculoskeletal causes, with costochondritis accounting for 14 percent of adolescent patients with chest pain. […] Costochondritis is a common diagnosis in adults with acute chest pain. It is present in 13 to 36 percent of these patients, depending on the study and the patient setting. […] In a prospective study of adult patients presenting to an emergency department with chest pain, 30 percent had costochondritis. […] A prospective study of episodes of care for chest pain in a primary care office network found musculoskeletal causes in 20 percent of episodes of care, with costochondritis responsible for 13 percent. […] These data are similar to a study of patients with noncardiac chest pain that found reproducible chest wall tenderness (although not specifically defined as costochondritis) in 16 percent of patients. […] A European study found a higher prevalence of musculoskeletal diagnoses in patients with chest pain presenting in primary care settings compared with hospital settings (20 versus 6 percent, respectively).
#27 Costochondritis – Wikipedia
https://en.wikipedia.org/wiki/Costochondritis
Costochondritis is a common condition that is responsible for approximately 13-36% of acute chest pain-related concerns from adults depending on the setting, with 14-39% for adolescents. […] It is most often seen in individuals who are older than 40 years of age and occurs more often in women than in men.
#28 Pediatric Costochondritis: Practice Essentials, Pathophysiology, Epidemiology
https://emedicine.medscape.com/article/1006486-overview
Several studies of chest pain in pediatric patients report costochondritis prevalences of 14-32%. […] A single study reported rates as high as 79%; however, this higher prevalence may be due to less stringent diagnostic criteria for costochondritis. The overall incidence is approximately 4% in children and adolescents. […] A study indicates Hispanics may have an increased prevalence of costochondritis, but most studies do not mention race as a factor. […] Studies of chest pain in children demonstrate that males and females are affected equally. There are no recent studies evaluating the effect of gender in costochondritis. […] No data support an association between age and costochondritis; the condition is well described in children of all ages, including infants.
#29 Costochondritis | 5-Minute Pediatric Consult
https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617108/all/Costochondritis?q=Escherichia+coli
Costochondritis accounts for 10-31% of all pediatric chest pain. […] Peak age for chest pain in children is 12 to 14 years. […] Frequency of sternal wound infections following median sternotomy is 0.1-1.6%.
#30 Pediatric Costochondritis: Practice Essentials, Pathophysiology, Epidemiology
https://emedicine.medscape.com/article/1006486-overview
Several studies of chest pain in pediatric patients report costochondritis prevalences of 14-32%. […] A single study reported rates as high as 79%; however, this higher prevalence may be due to less stringent diagnostic criteria for costochondritis. The overall incidence is approximately 4% in children and adolescents. […] A study indicates Hispanics may have an increased prevalence of costochondritis, but most studies do not mention race as a factor. […] Studies of chest pain in children demonstrate that males and females are affected equally. There are no recent studies evaluating the effect of gender in costochondritis. […] No data support an association between age and costochondritis; the condition is well described in children of all ages, including infants.
#31 Costochondritis Article
https://iiab.me/kiwix/content/statpearls_en_all_maxi_2020-11/A/articles/article-20071.html
The epidemiology of costochondritis is not well established. In a small study published in 1994, there was a higher frequency of costochondritis seen in females and Hispanics. In a group of 122 patients presenting to the emergency department with chest pain not due to malignancy, fever, or trauma, costochondritis was the diagnosis in 36 of the patients (30%). […] Costochondritis should be a diagnosis of exclusion. Rule out other causes of chest pain that are associated with increased morbidity and mortality.
#32 Costochondritis: Rapid Evidence Review. | EBSCOhost
https://search.ebscohost.com/login.aspx?direct=true&profile=ehost&scope=site&authtype=crawler&jrnl=0002838X&AN=151418663&h=rWCcCUqMtRE7reBguihrtwejho0XWLKbkT0naObX0g7pK5eSYeWEIfbvfg6yqj2QY%2Fy4ITnWcsT9ha%2B3xwD5Vg%3D%3D&crl=f
Costochondritis is a common cause of chest pain. It most commonly occurs in adults between 40 and 50 years of age, with a slight predominance in women. […] Although musculoskeletal and other chest wall conditions are the most common etiology for chest pain presenting to primary care, an initial differential diagnosis should include cardiovascular, psychogenic, pulmonary, gastrointestinal, and miscellaneous or unknown sources (more to less common, respectively). […] The diagnosis of costochondritis is largely based on history and a physical examination that demonstrates reproduction of pain through palpation of the parasternal region of the chest wall, performance of a crowing rooster maneuver, and/or a crossed-chest adduction maneuver.
#33 Costochondritis | PM&R KnowledgeNow
https://now.aapmr.org/costochondritis/
Review of literature approximates a 10% prevalence for musculoskeletal chest pain. In a 1994 emergency department study, 30% of patients with chest pain had costochondritis. Women comprised 69% of patients with costochondritis versus 31% in the control group. […] Avoidance of aggravating activities along with careful observation of proper mechanics during strenuous activities can help prevent occurrences. For example, in competitive rowers, costochondritis is typically noted in the sweep phase, and patients may experience pain during shoulder adduction. […] Environmental allergies that predispose to repeated sneezing or coughing may increase the risk of developing costochondritis. Professional or recreational activities that require repeated movements of the upper limbs and upper thoracic cage may also increase risk.
#34 Costochondritis | PM&R KnowledgeNow
https://now.aapmr.org/costochondritis/
Review of literature approximates a 10% prevalence for musculoskeletal chest pain. In a 1994 emergency department study, 30% of patients with chest pain had costochondritis. Women comprised 69% of patients with costochondritis versus 31% in the control group. […] Avoidance of aggravating activities along with careful observation of proper mechanics during strenuous activities can help prevent occurrences. For example, in competitive rowers, costochondritis is typically noted in the sweep phase, and patients may experience pain during shoulder adduction. […] Environmental allergies that predispose to repeated sneezing or coughing may increase the risk of developing costochondritis. Professional or recreational activities that require repeated movements of the upper limbs and upper thoracic cage may also increase risk.
#35 Costochondritis | PM&R KnowledgeNow
https://now.aapmr.org/costochondritis/
Review of literature approximates a 10% prevalence for musculoskeletal chest pain. In a 1994 emergency department study, 30% of patients with chest pain had costochondritis. Women comprised 69% of patients with costochondritis versus 31% in the control group. […] Avoidance of aggravating activities along with careful observation of proper mechanics during strenuous activities can help prevent occurrences. For example, in competitive rowers, costochondritis is typically noted in the sweep phase, and patients may experience pain during shoulder adduction. […] Environmental allergies that predispose to repeated sneezing or coughing may increase the risk of developing costochondritis. Professional or recreational activities that require repeated movements of the upper limbs and upper thoracic cage may also increase risk.
#36 Costochondritis: What It Is, Causes, FAQs & Treatment
https://my.clevelandclinic.org/health/diseases/22167-costochondritis
Costochondritis is one of the most common causes of chest pain. Experts estimate that around one-third of people who visit a healthcare provider with chest pain or rib pain have costochondritis. […] Diagnosing costochondritis is usually a diagnosis of elimination. This means a healthcare provider might do an exam and perform tests to rule out other, more serious conditions before diagnosing costochondritis. […] Anyone can develop costochondritis, but some people have a higher risk: Athletes who play contact sports, People with physically demanding jobs, Being female, Hispanic people.
#37 Costochondritis: What It Is, Causes, FAQs & Treatment
https://my.clevelandclinic.org/health/diseases/22167-costochondritis
Costochondritis is one of the most common causes of chest pain. Experts estimate that around one-third of people who visit a healthcare provider with chest pain or rib pain have costochondritis. […] Diagnosing costochondritis is usually a diagnosis of elimination. This means a healthcare provider might do an exam and perform tests to rule out other, more serious conditions before diagnosing costochondritis. […] Anyone can develop costochondritis, but some people have a higher risk: Athletes who play contact sports, People with physically demanding jobs, Being female, Hispanic people.
#38 Assessment of Correlation Between Costochondritis and Vitamin D Insufficiency in School-age Children
https://brieflands.com/articles/jcp-102388
In children, after serious cardiopulmonary conditions are considered, musculoskeletal disorders, such as costochondritis, are the significant causes of chest pain commonly attributed to the final diagnosis. Although the epidemiology of costochondritis is not well established, it is one of the common causes of chest pain in children. […] Previous studies emphasized the importance of examining and treating vitamin D deficiency in individuals diagnosed with costochondritis. […] In line with recent research, the present study showed that the concentration of vitamin D was significantly lower in the study groups than in the controls. […] Based on the present findings, there was a significant relationship between vitamin D deficiency and costochondritis in children; however, it is difficult to determine if deficiency is an incidental cause of costochondritis. Therefore, future studies should evaluate the relationship between costochondritis and vitamin D deficiency. […] Vitamin D insufficiency should be considered in individuals with costochondritis or bony sternal pain, and physicians should consider vitamin D deficiency as a risk factor for costochondritis.
#39 Assessment of Correlation Between Costochondritis and Vitamin D Insufficiency in School-age Children
https://brieflands.com/articles/jcp-102388
In children, after serious cardiopulmonary conditions are considered, musculoskeletal disorders, such as costochondritis, are the significant causes of chest pain commonly attributed to the final diagnosis. Although the epidemiology of costochondritis is not well established, it is one of the common causes of chest pain in children. […] Previous studies emphasized the importance of examining and treating vitamin D deficiency in individuals diagnosed with costochondritis. […] In line with recent research, the present study showed that the concentration of vitamin D was significantly lower in the study groups than in the controls. […] Based on the present findings, there was a significant relationship between vitamin D deficiency and costochondritis in children; however, it is difficult to determine if deficiency is an incidental cause of costochondritis. Therefore, future studies should evaluate the relationship between costochondritis and vitamin D deficiency. […] Vitamin D insufficiency should be considered in individuals with costochondritis or bony sternal pain, and physicians should consider vitamin D deficiency as a risk factor for costochondritis.
#40 Assessment of Correlation Between Costochondritis and Vitamin D Insufficiency in School-age Children
https://brieflands.com/articles/jcp-102388
In children, after serious cardiopulmonary conditions are considered, musculoskeletal disorders, such as costochondritis, are the significant causes of chest pain commonly attributed to the final diagnosis. Although the epidemiology of costochondritis is not well established, it is one of the common causes of chest pain in children. […] Previous studies emphasized the importance of examining and treating vitamin D deficiency in individuals diagnosed with costochondritis. […] In line with recent research, the present study showed that the concentration of vitamin D was significantly lower in the study groups than in the controls. […] Based on the present findings, there was a significant relationship between vitamin D deficiency and costochondritis in children; however, it is difficult to determine if deficiency is an incidental cause of costochondritis. Therefore, future studies should evaluate the relationship between costochondritis and vitamin D deficiency. […] Vitamin D insufficiency should be considered in individuals with costochondritis or bony sternal pain, and physicians should consider vitamin D deficiency as a risk factor for costochondritis.
#41 Assessment of Correlation Between Costochondritis and Vitamin D Insufficiency in School-age Children
https://brieflands.com/articles/jcp-102388.html
In children, after serious cardiopulmonary conditions are considered, musculoskeletal disorders, such as costochondritis, are the significant causes of chest pain commonly attributed to the final diagnosis. Although the epidemiology of costochondritis is not well established, it is one of the common causes of chest pain in children. […] Previous studies emphasized the importance of examining and treating vitamin D deficiency in individuals diagnosed with costochondritis. […] The present findings confirmed the significance of vitamin D supplementation for maintaining bone health during childhood. We suggest vitamin D measurement in pediatric patients with costochondritis. […] Vitamin D insufficiency should be considered in individuals with costochondritis or bony sternal pain, and physicians should consider vitamin D deficiency as a risk factor for costochondritis.
#42 Costochondritis | PM&R KnowledgeNow
https://now.aapmr.org/costochondritis/
Review of literature approximates a 10% prevalence for musculoskeletal chest pain. In a 1994 emergency department study, 30% of patients with chest pain had costochondritis. Women comprised 69% of patients with costochondritis versus 31% in the control group. […] Avoidance of aggravating activities along with careful observation of proper mechanics during strenuous activities can help prevent occurrences. For example, in competitive rowers, costochondritis is typically noted in the sweep phase, and patients may experience pain during shoulder adduction. […] Environmental allergies that predispose to repeated sneezing or coughing may increase the risk of developing costochondritis. Professional or recreational activities that require repeated movements of the upper limbs and upper thoracic cage may also increase risk.
#43 Tuberculosis presenting as Costochondritis: a rare case report and brief review of literature | British Journal of Medical Practitioners
https://www.bjmp.org/content/tuberculosis-presenting-costochondritis-rare-case-report-and-brief-review-literature
Thoracic wall tuberculosis is rare and primary tubercular costochondritis has been very rarely reported in the literature. […] Tuberculosis is an important and major infectious disease worldwide, especially in developing countries with an estimated global case fatality rate of 13% in 2007. […] Musculoskeletal tuberculosis is rare, chest wall tuberculosis is rarer and involvement of costochondral junction is among the rarest forms of tuberculosis. […] Tuberculosis of the chest wall constitutes 1 to 5% of all cases of musculoskeletal TB. […] TB abscesses of the chest wall are usually seen at the margins of the sternum and along the rib shafts, and can also involve the costochondral junctions, costovertebral joints and the vertebrae. […] In developing countries such as ours, tuberculosis is endemic and all the rare forms of the disease have been described, but in developed countries, resurgence of tuberculosis due to HIV may be responsible for atypical presentations.
#44 Chest wall abscess and costochondritis due to Salmonella enterica serotype Choleraesuis: a case report | Journal of Medical Case Reports | Full Text
https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-023-04229-w
We report a rare case of chest wall abscess with associated costochondritis due to S. enterica serotype Choleraesuis in a patient with no evidence of immunodeficiency nor history of bacteremia. […] Joint and bone infections due to nontyphoidal Salmonella do occur and have been reported in the literature. However, primary chest wall abscesses and costochondritis from these organisms are rare. […] Our case demonstrates a case of a nontyphoidal Salmonella chest wall abscess and costochondritis without an obvious source. We suspect the most likely scenario was a dissemination to the traumatized chest wall from an asymptomatic gastrointestinal infection with transient bacteremia. […] Diagnosis is often accomplished by clinical evaluation and culture of the affected area. Treatment usually involves appropriate antibiotic therapy guided by antibiotic susceptibility testing but may require surgical intervention to achieve source control and cure.
#45 SAPHOâa diagnosis to consider in patients with refractory costochondritis | Egyptian Rheumatology and Rehabilitation | Full Text
https://erar.springeropen.com/articles/10.1186/s43166-022-00144-y
SAPHO is a differential diagnosis in patients with chronic costochondritis. […] Persistence of symptoms and poor response to treatment with NSAID should raise suspicion for this diagnosis even in the absence of the typical skin features. […] Costochondritis is characterized by anterior chest wall pain without local swelling that is reproduced by palpation of the involved costosternal joints. […] Long-term persistence of symptoms (7 years in our patient) should be considered a red flag suggesting an alternative diagnosis. […] Imaging studies are important in making a diagnosis of SAPHO.
#46 Costochondritis | 5-Minute Pediatric Consult
https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617108/all/Costochondritis?q=Escherichia+coli
Costochondritis accounts for 10-31% of all pediatric chest pain. […] Peak age for chest pain in children is 12 to 14 years. […] Frequency of sternal wound infections following median sternotomy is 0.1-1.6%.
#47 Causes, symptoms, and treatment of Costochondritis
https://www.medicalnewstoday.com/articles/318797
Costochondritis is inflammation of the cartilage connecting the ribs and breastbone. […] The condition most commonly affects people ages 40-50 years old. […] According to an older study, an estimated 13-36% of those who seek emergency medical attention for chest pain are experiencing costochondritis. […] Although doctors have not defined how prevalent this condition is, they consider it a rare disorder. […] Costochondritis can last from a few weeks to months. […] The condition does not usually last longer than one year. However, adolescents with costochondritis can sometimes experience a longer period of symptoms.
#48 Causes, symptoms, and treatment of Costochondritis
https://www.medicalnewstoday.com/articles/318797
Costochondritis is inflammation of the cartilage connecting the ribs and breastbone. […] The condition most commonly affects people ages 40-50 years old. […] According to an older study, an estimated 13-36% of those who seek emergency medical attention for chest pain are experiencing costochondritis. […] Although doctors have not defined how prevalent this condition is, they consider it a rare disorder. […] Costochondritis can last from a few weeks to months. […] The condition does not usually last longer than one year. However, adolescents with costochondritis can sometimes experience a longer period of symptoms.
#49 Causes, symptoms, and treatment of Costochondritis
https://www.medicalnewstoday.com/articles/318797
Costochondritis is inflammation of the cartilage connecting the ribs and breastbone. […] The condition most commonly affects people ages 40-50 years old. […] According to an older study, an estimated 13-36% of those who seek emergency medical attention for chest pain are experiencing costochondritis. […] Although doctors have not defined how prevalent this condition is, they consider it a rare disorder. […] Costochondritis can last from a few weeks to months. […] The condition does not usually last longer than one year. However, adolescents with costochondritis can sometimes experience a longer period of symptoms.
#50 Causes, symptoms, and treatment of Costochondritis
https://www.medicalnewstoday.com/articles/318797
Costochondritis is inflammation of the cartilage connecting the ribs and breastbone. […] The condition most commonly affects people ages 40-50 years old. […] According to an older study, an estimated 13-36% of those who seek emergency medical attention for chest pain are experiencing costochondritis. […] Although doctors have not defined how prevalent this condition is, they consider it a rare disorder. […] Costochondritis can last from a few weeks to months. […] The condition does not usually last longer than one year. However, adolescents with costochondritis can sometimes experience a longer period of symptoms.
#51 SAPHOâa diagnosis to consider in patients with refractory costochondritis | Egyptian Rheumatology and Rehabilitation | Full Text
https://erar.springeropen.com/articles/10.1186/s43166-022-00144-y
SAPHO is a differential diagnosis in patients with chronic costochondritis. […] Persistence of symptoms and poor response to treatment with NSAID should raise suspicion for this diagnosis even in the absence of the typical skin features. […] Costochondritis is characterized by anterior chest wall pain without local swelling that is reproduced by palpation of the involved costosternal joints. […] Long-term persistence of symptoms (7 years in our patient) should be considered a red flag suggesting an alternative diagnosis. […] Imaging studies are important in making a diagnosis of SAPHO.
#52 Costochondritis Article
https://iiab.me/kiwix/content/statpearls_en_all_maxi_2020-11/A/articles/article-20071.html
The epidemiology of costochondritis is not well established. In a small study published in 1994, there was a higher frequency of costochondritis seen in females and Hispanics. In a group of 122 patients presenting to the emergency department with chest pain not due to malignancy, fever, or trauma, costochondritis was the diagnosis in 36 of the patients (30%). […] Costochondritis should be a diagnosis of exclusion. Rule out other causes of chest pain that are associated with increased morbidity and mortality.
#53 Costochondritis: Rapid Evidence Review. | EBSCOhost
https://search.ebscohost.com/login.aspx?direct=true&profile=ehost&scope=site&authtype=crawler&jrnl=0002838X&AN=151418663&h=rWCcCUqMtRE7reBguihrtwejho0XWLKbkT0naObX0g7pK5eSYeWEIfbvfg6yqj2QY%2Fy4ITnWcsT9ha%2B3xwD5Vg%3D%3D&crl=f
Costochondritis is a common cause of chest pain. It most commonly occurs in adults between 40 and 50 years of age, with a slight predominance in women. […] Although musculoskeletal and other chest wall conditions are the most common etiology for chest pain presenting to primary care, an initial differential diagnosis should include cardiovascular, psychogenic, pulmonary, gastrointestinal, and miscellaneous or unknown sources (more to less common, respectively). […] The diagnosis of costochondritis is largely based on history and a physical examination that demonstrates reproduction of pain through palpation of the parasternal region of the chest wall, performance of a crowing rooster maneuver, and/or a crossed-chest adduction maneuver.
#54 Musculoskeletal chest wall pain
https://www.racgp.org.au/afp/2015/august/musculoskeletal-chest-wall-pain
There is a lack of clinical trials for costochondritis treatments and only low-level or consensus evidence for currently accepted treatment approaches. As far as we are aware, costochondritis is usually a self-limiting, benign condition and treatment, therefore, begins with reassurance and explanation of the condition to the patient.
#55 Musculoskeletal chest wall pain
https://www.racgp.org.au/afp/2015/august/musculoskeletal-chest-wall-pain
In one general practice sample, costochondritis, also known as costosternal syndrome and anterior chest wall syndrome, was the most common specific cause of anterior musculoskeletal chest pain, with a prevalence of 13%. Patients with costochondritis typically present with multiple areas of tenderness without swelling over the costochondral or costosternal junctions, palpation of which reproduces their pain. Most commonly, the cause is unknown. It differs from the rarer Tietzes disease, which typically involves only one area with associated painful, localised swelling. […] The evidence base for interventions specifically targeting MCWP is very limited. A recent systematic review of interventions for non-cardiac chest pain identified only two randomised controlled trials (RCTs) addressing musculoskeletal causes.