Costochondritis is a common cause of chest pain in children.  It involves irritation at the connection point of the front ribs and the breast plate.  The pain may be dull or sharp but often worsens with movement of the chest wall or deep breathing.  The pain returns when an examiner presses on the rib-sternum connection points.  Here, cartilage may be injured by excess or new physical activity.  The pain may persist for several days or longer because of frequent movement of the chest wall (i.e., bending over, carrying a heavy backpack, sports activity, etc.).  Costochondritis often causes unnecessary anxiety due to a fear of a cardiac cause of chest pain.  Chest pain in children is rarely caused by the heart.  The treatment for costochondritis involves anti-inflammatory medications (i.e., ibuprofen) and reassurance.  Most cases will resolve with rest and time.

What is costochondritis?

Costochondritis is a common cause of chest pain in children.  Up to 31% of pediatric chest pain cases are due to this condition.  The condition itself is harmless but may cause pain and discomfort.  Many children present to a physician for fear of a possible cardiac cause of chest pain.

What causes costochondritis?

• Many cases have no known cause.
• Repetitive movements (i.e., digging, throwing a ball) 
• New types of physical activity (i.e., a child who just got a new trampoline or jump rope)
• A known chest injury 

How is costochondritis diagnosed? 

• A physician applies pressure to the front of the chest at the point where the ribs meet the breastplate.  The cartilage in these areas causes pain when pressed. 
• Other causes of chest pain may need to be explored.
• A chest X-ray is typically normal and not helpful for diagnosis. 

How is costochondritis treated? 

• Nonsteroidal anti-inflammatory drugs (NSAID's) such as ibuprofen, Motrin, or Advil.
• Limiting excess movement (although extended periods of rest are typically not necessary).

What are the possible complications of costochondritis?

Rarely, costochondritis may be associated with an infection.  These children typically have fever, severe pain, and are ill-appearing. 

When should I be worried about costochondritis?

• If symptoms are severe or persistent 
• If your child appears ill 
• If your child has an unexplained fever 
• If your child complains of a funny or abnormal heartbeat 
• If the pain causes dizziness or passing out 

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