• Anterior chest wall pain and tenderness of the costochondral and costosternal regions, most often affecting the 2nd to the 5th costal cartilages
  • System(s) affected: musculoskeletal
  • Synonym(s): costosternal syndrome; parasternal chondrodynia; anterior chest wall syndrome


  • Predominant age: 40 to 50 years
  • Predominant gender: female


  • 30% emergency room visits for chest pain
  • 13% primary care visits for chest pain

Etiology and Pathophysiology

Although not fully understood, inflammation can be caused by pulling from adjoining muscles at costochondral or costosternal regions.

Risk Factors

  • Unusual physical activity or upper extremity overuse
  • Recent trauma (including motor vehicle accident, domestic violence) or new-onset physical activity
  • Recent upper respiratory infection (URI) with coughing

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