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Costochondritis

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  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources
Last reviewed: 29 Sep 2025
Last updated: 28 Oct 2024

Summary

Definition

History and exam

Key diagnostic factors

  • chest pain
  • chest-wall tenderness
Full details

Other diagnostic factors

  • chest-wall swelling
Full details

Risk factors

  • microtrauma
  • female sex
  • age >40 years
  • sternotomy wound infection
  • intravenous drug use
Full details

Diagnostic investigations

1st investigations to order

  • nonsteroidal anti-inflammatory drug trial
Full details

Investigations to consider

  • local anesthetic and corticosteroid trial
  • chest x-ray
  • CT chest
  • MRI chest
  • wound or blood cultures
Full details

Treatment algorithm

ACUTE

inflammatory

infectious

Contributors

Authors

Fadi Badlissi, MD, MSc
Fadi Badlissi

Attending Physician

Medical Director of the Musculoskeletal Medical Unit

Department of Orthopedics & Division of Rheumatology

Beth Israel Deaconess Medical Center

Assistant Professor of Medicine

Harvard Medical School

Boston

MA

Disclosures

FB has been reimbursed by ANI Pharmaceuticals and Janssen and Amgen for attending an advisory board meeting.

Peer reviewers

Don L. Goldenberg, MD

Emeritus Professor of Medicine

Tufts University School of Medicine

Boston

MA

Disclosures

DLG declares that he has no competing interests.

Richard G. Chang, MD, MPH, FAAPMR

Associate Program Director

Sports Medicine Fellowship

Assistant Professor of Medicine

Icahn School of Medicine at Mount Sinai

New York

NY

Disclosures

RGC declares that he is the President of the New York Society Of Physical Medicine and Rehabilitation (2023-2025), is State Advocacy Chair and a Health Policy and Legislative Committee member for the American Academy of Physical Medicine and Rehabilitation, and is a Health Policy Division and Ultrasound Education Committee member for the Spine Intervention Society.

Richard Wakefield, BM, FRCP, MD

Senior Lecturer in Rheumatology

Section of Musculoskeletal Disease

Leeds Institute of Molecular Medicine

Chapel Allerton Hospital

Leeds

UK

Disclosures

RW declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Mott T, Jones G, Roman K. Costochondritis: rapid evidence review. Am Fam Physician. 2021 Jul 1;104(1):73-8.Full text

Proulx AM, Zryd TW. Costochondritis: diagnosis and treatment. Am Fam Physician. 2009 Sep 15;80(6):617-20.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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