Inflammation of the Claviculosternal Joint is NOT Costochondritis
No, inflammation of the claviculosternal (sternoclavicular) joint is not classified as costochondritis. These are distinct anatomical entities with different definitions according to the American Heart Association and American College of Cardiology clinical data standards. 1
Key Anatomical Distinctions
Costochondritis specifically refers to inflammation of the costochondral junctions (where ribs meet costal cartilage) or the chondrosternal joints (where costal cartilages meet the sternum). 1 The condition involves inflammation of one or more ribs and/or their cartilages, but does not include the sternoclavicular joint. 1
The sternoclavicular joint is the articulation between the clavicle and the sternum—a completely separate anatomical structure from the rib-cartilage junctions. 2
Related but Separate Conditions
Sternoclavicular Joint Inflammation
- Inflammatory arthropathies such as spondyloarthritis and SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis, and osteitis) can involve the sternoclavicular joint. 2
- These conditions typically present with pain and are often bilateral, distinguishing them from costochondritis. 2
- Bone scintigraphy has been reported to be 100% sensitive for detecting sternoclavicular joint inflammation in patients with anterior chest wall pain. 2
Tietze Syndrome
- This is a distinct condition involving localized inflammation of at least one joint between the rib and costal cartilage, often with visible swelling. 1
- Unlike costochondritis, Tietze syndrome typically presents with palpable swelling at the affected costochondral junction. 3
Clinical Implications
When evaluating anterior chest wall pain, it is critical to distinguish between:
- Costochondritis: Tenderness at costochondral or chondrosternal junctions (ribs 2-7 typically). 3
- Sternoclavicular joint pathology: Tenderness and possibly swelling at the junction of the clavicle and sternum. 2
- Tietze syndrome: Costochondral inflammation with visible swelling. 3
The distinction matters because sternoclavicular joint involvement may indicate systemic inflammatory conditions like spondyloarthritis or SAPHO syndrome, which require different diagnostic workup and management than isolated costochondritis. 2