When patients come to me with pain in the chest and I feel swelling and they hurt when I press on ribs just to the side of the large bone in the middle of the chest, I often diagnose a usually harmless condition called Tietze’s syndrome, also known as costochondritis.

Chest pain can be a sign of a heart attack, so doctors usually order an electrocardiogram, a chest X ray and several blood tests. Even if all the tests are normal, they may still hospitalize the patient because normal tests do not rule out a heart attack. Chest pain can also be caused by a pinched nerve in your back, a stomach ulcer, gall bladder disease and so forth, so it is often reassuring when a patient feels pain when a doctor presses on the ribs because the heart is inside a bony cavity and should not hurt when a doctor presses on a person’s chest.

Your ribs attach to a large bone in the center of your chest in the front. To help you breathe in, your muscles raise your rib cage and to help you breathe out, they relax and let your ribs drop. Therefore, your ribs form a movable joint where they attach to your chest bone. It is common for people to get arthritis in these joints which hurts particularly when they breathe. Tietze’s syndrome usually goes away in a few weeks or months with no treatment. However, your doctor may offer to block the pain with arthritis medication or a xylocaine injection into the painful joint.

Checked 4/3/14