Disorder | Clinical manifestations |
Muscle strains | Particularly of the intercostal muscles. Tenderness over the affected muscle is present and increases with stretching the muscle (eg, taking a deep breath). |
Costosternal syndromes (costochondritis) | Multiple areas of tenderness that reproduce the described pain, usually in the upper costal cartilages at the costochondral or costosternal junctions; there is no swelling. |
Tietze syndrome | Painful, nonsuppurative localized swelling of the costosternal, sternoclavicular, or costochondral joints, most often involving one joint in the area of the second and third ribs; rare, primarily affects young adults. |
Sternalis syndrome | Localized tenderness over the body of the sternum or overlying sternalis muscle; palpation often causes radiation of pain bilaterally. |
Xiphoidalgia | Localized discomfort over the sternum at the xiphoid process. |
Spontaneous sternoclavicular subluxation | Most often occurs in the dominant side, associated with moderate to heavy repetitive tasks; almost exclusively occurs in middle-aged women. |
Lower rib pain syndromes | Pain in the lower chest or upper abdomen with a tender spot on the costal margin; pain can be reproduced by pressing on the spot. |
Posterior chest wall syndromes | May be caused by herniated thoracic disc, leading to band-like chest pain that may have a unilateral dermatomal distribution. Also induced by costovertebral joint dysfunction; tenderness over the affected area, worse with coughing or deep breathing. |
Osteoarthritis of the sternoclavicular joint | Can cause focal pain of the sternoclavicular joint. |
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