Second rib cartilage pain



Costal cartilage inflammation is slow onset. Its prominent clinical manifestations are affected gastric cartilage bulging, swelling, obvious spontaneous pain and tenderness, local redness and heat changes. In most cases, only a single costal cartilage is invaded, and there are also more than 2 cases or multiple bilateral costal cartilage in individual cases. The most common lesion-prone site is the left second costal cartilage, followed by the right second costal cartilage and the third, fourth, first costal cartilage.



The cause is unknown. It has been reported to be associated with tuberculosis, systemic malnutrition, acute bacterial and viral upper respiratory tract infections, rheumatoid arthritis, thoracolumbar subluxation, chronic chest and ligament ligament injury, chest impact injury, severe cough, etc. This disease often occurs at the turn of winter and spring and the season of autumn and winter, and is obviously related to the invasion of wind, cold and dampness. Some people who use broad-spectrum antibiotics have obvious effects. This disease often invades the second costal cartilage, accounting for about 70%, followed by the third, fourth and first costal cartilage. This is closely related to a thoracic rib ligament at the junction of the second costal cartilage and the sternum. The ligament handle and the sternum are connected to the fibrous tissue there. Some people think that costal cartilage inflammation is a slight injury to the thoracic ligament or rheumatoid arthritis, or the inflammation of the ligament caused by both.


an examination

Related inspection

Bone and joint MRI examination of bone and joint plain films of extremities

Although the diseased gastric cartilage is enlarged and bulged, the surface is smooth and the boundary is clear. There is no red, swollen, hot and other inflammatory changes on the surface skin. The degree of pain and tenderness in the affected area varies. Severe cases of cough, deep breathing, turning activities, lifting the upper limbs, intercostal muscles and pectoralis major muscles involved in pain, partial rejection. Some cases have general malaise, loss of appetite, and low fever. The patient did not dare to raise his chest and his spirits were sluggish. The main symptom of costal cartilage is local pain. It usually lasts for 2 to 3 months and can be relieved or disappeared by itself. However, the costal cartilage is enlarged and the bulging will continue for many years. In some cases, when the time is good, the time is light and heavy, and it is delayed for several years.


Differential diagnosis

Differential diagnosis of the second costal cartilage pain:

1, side rib pain: experts do not know what causes rib pain, it is generally considered to be related to daily life, such as exercise beyond the ability, improper sucking, dehydration or exercise immediately after meals.

2. Swelling and pain of the sterno-lock joint: The sterno-lock joint is a movable joint composed of the synovial membrane, the joint capsule and the articular cartilage. The thoracic rib joint is a movable joint composed of a combination of the sternum and costal cartilage. Thoracic joint swelling and pain, many causes, such as joint dislocation, joint tuberculosis, septic arthritis, rheumatoid or rheumatoid arthritis, traumatic arthritis, joint tumors. There is a clear difference from costal cartilage.

3, rib vertebral body tenderness: cirrhosis, portal pressure increased, more than 200 mm water column, the normal digestive organs and spleen return blood flow through the liver blocked, resulting in many parts of the portal system and the vena cava between the door - Collateral circulation. Due to the portal hypertension of cirrhosis, the normal hepatic portal vein obstruction, the blood through the two anastomosis into the vena cava system, due to the small veins in the anastomosis, the blood flow will be varicose, once ruptured can lead to major bleeding, such as hematemesis, blood in the stool, around the umbilicus You will see the veins of the varicose veins.

4, rib pain: the ribs corresponding to the back of the thoracic vertebrae have a slight shift, causing the rib nerve to be stuck or stuck, it will be painful. There is muscle damage at the point of pain that produces a sterile inflammation station that stimulates the rib nerve to cause pain.

5, costal cartilage inflammation and chest wall tuberculosis, rib suppurative osteomyelitis differentiated chest tube tuberculosis with systemic tuberculosis, rapid blood sedimentation, cold abscess, x-ray film can be seen tuberculous bone destruction. Osteomyelitis has purulent lesions and symptoms of systemic infection, and the blood picture changes significantly. X-ray films can be seen in the bone marrow inflammatory nature of bone destruction.