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costochondritis in commen between adult 40-50 years of age.  It is an inflammation of the chest wall, that occurs on both sides of the chest wall, and worsen by deep breaths, coughing and stretching.  There is no readness, no swelling, or heat at the tender area on the chest.  

Other possible diagnoses can be herpes zoster before the rash eruption, fibromyalgia, slipping rib syndrome, painful xyphoid syndrome, tietze syndrom (this will cause swelling of a single tender costochondral junction), overuse or trauma of the muscle. 

no xray or other imaging test is necessary. The physical exam (crowing rooster manuver) is sufficient to diagnosis costochrondritis.  Treatment involves NSAID, and 91% patients are better after 3 weeks.  Acupunture and PT can be considered if not better after 3 weeks. 


SHAWN HAMILTON, MD, MBA Internal medicine physician with 20 year of experience as PCP.

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