Last reviewed: 24 Feb 2023
Last updated: 06 Apr 2022
Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- chest pain
- chest-wall tenderness
More key diagnostic factors
Other diagnostic factors
- chest-wall swelling
Other diagnostic factors
Risk factors
- microtrauma
- female sex
- Hispanic ethnicity
- age >40 years
- sternotomy wound infection
- intravenous drug use
More risk factors
Diagnostic investigations
1st investigations to order
- non-steroidal anti-inflammatory drug trial
More 1st investigations to order
Investigations to consider
- local anaesthetic and corticosteroid trial
- chest x-ray
- CT chest
- MRI chest
- wound or blood cultures
More investigations to consider
Treatment algorithm
ACUTE
inflammatory
infective
Contributors
Authors
Fadi Badlissi, MD, MSc
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 declares that he has no competing interests.
Peer reviewers
Don Aspegren, DC, MS
Assistant Clinical Professor
Department of Rehabilitation
University of Colorado School of Medicine
Lakewood
CO
Disclosures
DA declares that he has no competing interests.
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.
Differentials
- Acute coronary syndrome
- Pleuritis
- Pulmonary embolism
More Differentials
Log in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer