Medical Questions » Chest Questions » Question No. 197
| Question: | I am 47 years old and have pain in the first two left ribs where they meet the sternum. X-rays are normal, and the pain has come and gone at intervals over the last fifteen years. As I am a smoker, I am very worried this may be cancer. I would be thankful for your frank advice. |
| Answer: | Tietze syndrome (also known as costochondritis).
It is often difficult from vague, rambling letters to make any guess at a diagnosis, but from your succinct description of your symptoms, I would almost bet that this relatively common syndrome is the cause of your problem.
The ribs come around the chest from the back towards the breast bone. They stop some centimetres short of the breast bone though, and a strip of cartilage (the costal cartilage) joins the end of the rib to the side of the breast bone. This strip of cartilage gives the rib cage additional spring, flexibility and tesilience.
In some people, often young women, but potentially anybody, one or more of these cartilages becomes inflamed, painful, tender and slightly swollen. The cause for this reaction is unknown, but it was first described by the nineteenth-century German surgeon, Alexander Tietze—thus Tietze syndrome.
The problem may last for weeks or months before settling, and then recur at a later time. There are no serious complications of the condition, but the victim may be significantly discomforted by the pain.
Treatment involves the use of high doses of anti-inflammatory tablets, or occasionally, brief courses of steroids. These are only available on prescription, so I suggest that you discuss the possibility of this syndrome causing your pain with your GP.
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