Other musculoskeletal conditions that may cause chest pain similar to costochondritis includes but are not limited to, painful xiphoid syndrome, muscle strain, myofascial pain syndrome, thoracic disk herniation, and rib fracture. Other
Rheumatologic conditions such as fibromyalgia, SAPHO syndrome, ankylosing spondylitis, rheumatoid arthritis, and psoriatic arthritis can cause symptoms similar to costochondritis. Oncology-related conditions, namely neoplasms and myelomatous pleural effusion have been associated with chest pain. Chest pain is occasionally experienced with respiratory-related conditions such as pleuritis, precordial catch syndrome, and pneumonia. Psychogenic conditions such as anxiety disorders, panic disorders, and hyperventilation syndrome may cause chest pain. Some gastroenterology conditions may be associated with costochondritis-like chest pain such as gastroesophageal reflux disease, and esophagitis. Viral infections such as herpes zoster and Bornholm disease are seen as differential diagnoses for costochondritis due to chest pain being a reported symptom. Vitamin D deficiency can be a differential diagnosis for costochondritis as it may cause chest pain. Chest pain has also been reported following the use of cocaine, which can increase the risk of various cardiovascular conditions. Treatment
Costochondritis is referred to as being self-limited, which is a condition in which will typically resolve on its own without treatment. Conservative methods are often the first method to treat the condition. If the condition is a result of trauma or over-use of the upper extremity, individuals will be told to rest and avoid activities. Pain relief medications (analgesics) such as acetaminophen, or the use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, or meloxicam may be suggested to relieve discomfort.
It affects primarily the 2nd to 5th ribs at the sternocostal and costochondral joints. The most commonly reported symptom of costochondritis is chest pain that is often exacerbated by movement and deep breathing. Pain is typically widespread and reproducible with palpation of the anterior (front) chest at the affected joints. : 171  Pain from costochondritis can vary between individuals, and is typically described as a sharp, aching, dull, or pressure-like pain. It may also be accompanied by a radiating pain to the shoulder, arm, front neck, or scapula (shoulder blade). : 550 The condition usually onsets gradually following repetitive coughing, strenuous physical activity, or trauma to the chest. : 171  Symptoms of costochondritis may be recurrent and last weeks to months; however, refractory cases of the condition can persist to over a year.Costochondritis does not present with heat, erythema, or swelling of the affected area, the presence of which would indicate Tietze syndrome. : 171  Additionally, symptoms such as tachycardia, hypotension, radiating pain, shortness of breath, fever, nausea, or a productive cough are unrelated to costochondritis. These signs warrant further investigation for other, more serious causes of chest pain. Cause
The exact etiology of costochondritis is unknown. Repetitive minor trauma is proposed to be a likely cause, with risk factors such as strenuous coughing, exercise, and lifting identified.Infection of the costosternal joint may cause costochondritis in rare cases. Most cases of infectious costochondritis are caused by Actinomyces, Staphylococcus aureus, Candida albicans, and Salmonella. In rare cases, Escherichia coli can be a cause of infectious costochondritis.