The costochondral joints unite each rib to its costal cartilage at the osteochondral junction. The seventh through tenth costal cartilages meet each other at the interchondral joints rather than attaching directly to the sternum. Costochondritis (inflammation at the costochondral junction) produces the reproducible anterior chest pain on palpation that must be distinguished from cardiac and pleuropulmonary chest pain. Tietze syndrome involves visible swelling at the second or third costochondral joint.
Costochondritis reproduces chest pain by firm palpation directly over the affected costochondral junction. Multiple adjacent junctions are often tender (2nd-5th most common). NSAIDs and local injection provide relief. Tietze syndrome is distinguished by visible swelling at the affected junction — usually a single upper junction (2nd or 3rd).
Costochondral junction inflammation producing reproducible anterior chest pain on palpation managed with NSAIDs and targeted injection.
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