eMedicine Specialties > Pediatrics: General Medicine > Rheumatology

Costochondritis: Follow-up

Author: Joseph P Garry, MD, Director of Sports Medicine and Sports Medicine Fellowship, Associate Professor of Family Medicine and Exercise & Sport Science, Department of Family Medicine, East Carolina University Brody School of Medicine
Coauthor(s): Barry L Myones, MD, Associate Professor, Departments of Pediatrics and Immunology, Pediatric Rheumatology Section, Baylor College of Medicine; Director of Research, Pediatric Rheumatology Center, Texas Children's Hospital
Contributor Information and Disclosures

Updated: Nov 8, 2007

Follow-up

Further Outpatient Care

  • Follow up as needed after initial diagnosis. Reevaluate patient if the nature, character, or severity of pain changes.
  • For individuals who participate in athletics, follow up at 2 weeks or sooner and instruct patient to return to activity only with medical clearance.

Prognosis

  • The overall prognosis of a patient with costochondritis is excellent; full recovery can be expected.
  • Resolution occurs in several weeks or months and rarely lasts longer than 4-6 months. Relapse may occur if the patient returns to activity while still symptomatic.

Patient Education

Miscellaneous

Medicolegal Pitfalls

  • Failure to consider the broad list of chest pain causes may lead to missing the diagnosis of an underlying or concomitant disease process.
  • Changes in the nature or character of the chest pain in costochondritis warrant a thorough interval history and physical examination to exclude a new diagnosis or disease process.

Special Concerns

  • Changes in the biomechanics associated with pregnancy may contribute to the development of costochondritis. Pay particular attention to the lower costochondral cartilage.
  • Acetaminophen and ice may be used for analgesia and treatment.
  • Avoid NSAIDs, particularly in the third trimester.
  • International Classification of Diseases, Ninth Revision (ICD-9) codes are "733.6 costochondritis" and "786.52 anterior chest wall pain." Current procedural terminology (CPT) billing code for a costochondral joint injection procedure is "20600 - arthrocentesis, injection; small joint."
 


More on Costochondritis

Overview: Costochondritis
Differential Diagnoses & Workup: Costochondritis
Treatment & Medication: Costochondritis
Follow-up: Costochondritis
References
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References

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  11. Mendelson G, Mendelson H, Horowitz SF et al. Can (99m)-technitium methylene diphosphonate bone scan objectively document costochondritis?. Chest. 1997;111(6):1600-1602.

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Further Reading

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Keywords

chest wall syndrome, costochondral syndrome, costosternal chondrodynia, Tietze syndrome, chest pain, costal chondritis, costochondral joint, costochondritis, costochondral cartilage, crepitus

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Contributor Information and Disclosures

Author

Joseph P Garry, MD, Director of Sports Medicine and Sports Medicine Fellowship, Associate Professor of Family Medicine and Exercise & Sport Science, Department of Family Medicine, East Carolina University Brody School of Medicine
Joseph P Garry, MD is a member of the following medical societies: American Academy of Family Physicians, American College of Sports Medicine, American Heart Association, American Medical Society for Sports Medicine, North American Primary Care Research Group, and North Carolina Medical Society
Disclosure: Nothing to disclose.

Coauthor(s)

Barry L Myones, MD, Associate Professor, Departments of Pediatrics and Immunology, Pediatric Rheumatology Section, Baylor College of Medicine; Director of Research, Pediatric Rheumatology Center, Texas Children's Hospital
Barry L Myones, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American College of Rheumatology, American Heart Association, American Society for Microbiology, Clinical Immunology Society, and Texas Medical Association
Disclosure: Nothing to disclose.

Medical Editor

James M Oleske, MD, MPH, François-Xavier Bagnoud Professor of Pediatrics, Director, Division of Pulmonary, Allergy, Immunology and Infectious Diseases, Department of Pediatrics, New Jersey Medical School
James M Oleske, MD, MPH is a member of the following medical societies: Academy of Medicine of New Jersey, American Academy of Pediatrics, American Public Health Association, American Society for Microbiology, Infectious Diseases Society of America, and Pediatric Infectious Diseases Society
Disclosure: "no financial interest" None None

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine.com, Inc
Disclosure: Nothing to disclose.

Managing Editor

David D Sherry, MD, Professor of Pediatrics, Division of Rheumatology, University of Pennsylvania; Director of Clinical Rheumatology, Children's Hospital of Philadelphia
David D Sherry, MD is a member of the following medical societies: American College of Rheumatology and American Pain Society
Disclosure: Nothing to disclose.

CME Editor

Daniel Rauch, MD, FAAP, Director, Pediatric Hospitalist Program, Associate Professor, Department of Pediatrics, New York University School of Medicine
Daniel Rauch, MD, FAAP is a member of the following medical societies: Ambulatory Pediatric Association, American Academy of Pediatrics, and Society of Hospital Medicine
Disclosure: Nothing to disclose.

Chief Editor

Barry L Myones, MD, Associate Professor, Departments of Pediatrics and Immunology, Pediatric Rheumatology Section, Baylor College of Medicine; Director of Research, Pediatric Rheumatology Center, Texas Children's Hospital
Barry L Myones, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American College of Rheumatology, American Heart Association, American Society for Microbiology, Clinical Immunology Society, and Texas Medical Association
Disclosure: Nothing to disclose.

 
 
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