From the Guidelines
Yes, costochondritis can present unilaterally, affecting just one side of the chest. This condition is characterized by inflammation of the cartilage that connects the ribs to the breastbone (sternum), and while it often affects multiple sites on both sides of the chest, it can commonly present with pain on only one side, particularly the left side, as noted in the context of evaluating chest pain 1. The key features of costochondritis include:
- Sharp, aching, or pressure-like pain that worsens with deep breathing, coughing, or physical activity
- Tenderness to palpation of the affected costal cartilages, which is the hallmark finding on physical examination
- Potential for the pain to be mistaken for cardiac pain due to its unilateral presentation
- Diagnosis primarily through physical examination, with a focus on identifying tenderness of the costochondral joints 1
- Treatment typically involving rest, over-the-counter pain relievers, and application of heat or ice to the affected area, with more severe cases potentially requiring local lidocaine injections or intercostal nerve blocks. The unilateral presentation of costochondritis can be attributed to various factors, including biomechanical issues, postural problems, or previous injury to one side of the chest wall, highlighting the importance of a thorough clinical evaluation to accurately diagnose and manage this condition.
From the Research
Presentation of Costochondritis
- Costochondritis can present unilaterally, as seen in a case report of a 37-year-old healthy male patient who presented with a two-year history of intermittent pain along the right anterolateral rib cage without any history of trauma 2.
- A study of 100 adolescent clinic patients found that costochondritis was more often unilateral than bilateral, with the left side more frequently involved than the right 3.
- Unilateral costochondritis can be effectively treated with a multimodal approach, including manipulative therapy, instrument-assisted soft tissue mobilization, and stretching 2.
Characteristics of Unilateral Costochondritis
- Unilateral costochondritis can manifest as non-cardiac chest pain, which is reproducible by palpating the affected costal cartilage 3.
- The pain can radiate into the chest, back, or abdomen, and is often involved in the left fourth sternocostal cartilage 3.
- A simple program of mild analgesics and reassurances can be sufficient treatment for unilateral costochondritis in adolescents 3.
Treatment of Unilateral Costochondritis
- External application of herbal medicines, such as Rhizoma Corydalis and borneol, can be an effective treatment for unilateral costochondritis, as seen in a case report of a 21-year-old female collegiate taekwondo athlete 4.
- Manipulative therapy, including osteopathic manipulation techniques, can also be useful in the treatment of unilateral costochondritis, especially in cases of atypical costochondritis 2.