Disla E, Rhim H R, Reddy A, Karten I, Taranta A
Department of Medicine, Cabrini Medical Center, New York, NY.
Arch Intern Med. 1994 Nov 14;154(21):2466-9. doi: 10.1001/archinte.154.21.2466.
Costochondritis (CC) is a common, but poorly understood condition among patients with chest wall pain. We have prospectively analyzed distinctive features of patients presenting to the emergency department with chest pain and CC.
Patients with a chief complaint of chest pain, not due to trauma, fever, or malignancy, were prospectively evaluated for the presence of CC and compared with another chest pain group without CC.
Of 122 consecutive patients studied, 36 had CC (30%) and in 17 the pain induced reproduced the original one (15%). Women made up 69% of the patients with CC (vs 31% of control subjects) and Hispanics 47% (vs 24% of control subjects). Only three patients (8%) with CC met the American College of Rheumatology criteria for fibromyalgia, while none of the control subjects did. Widespread pain was more common in the CC group (42% vs 5%). The mean sedimentation rate in the CC group was 44 +/- 31 mm/h vs 41 +/- 31 mm/h in the control group. The acute myocardial infarction rate was 6% in the CC group vs 28% in the control group. Rheumatoid arthritis and osteoarthritis were diagnosed in three and two patients, respectively, of 32 patients with CC cases. One year later, 11 (55%) of 21 patients with CC were still suffering from chest pain, but only one third still had definite CC.
Costochondritis is common among patients with chest pain in an emergency department setting, with a higher frequency among women and Hispanics. It is associated with fibromyalgia in only a minority of cases. Patients with CC appear to have a lower frequency of acute myocardial infarction. Spontaneous resolution is seen in most cases at 1 year.
肋软骨炎（CC）是胸壁疼痛患者中常见但了解甚少的一种病症。我们对因胸痛和肋软骨炎就诊于急诊科的患者的独特特征进行了前瞻性分析。
对以胸痛为主诉且非因创伤、发热或恶性肿瘤引起的患者进行前瞻性评估，以确定是否存在肋软骨炎，并与另一组无肋软骨炎的胸痛患者进行比较。
在连续研究的122例患者中，36例患有肋软骨炎（30%），其中17例（15%）疼痛诱发试验再现了原疼痛。女性占肋软骨炎患者的69%（对照组为31%），西班牙裔占47%（对照组为24%）。仅有3例（8%）肋软骨炎患者符合美国风湿病学会纤维肌痛标准，而对照组无一例符合。广泛性疼痛在肋软骨炎组更常见（42%对5%）。肋软骨炎组的平均血沉率为44±31mm/h，而对照组为41±31mm/h。肋软骨炎组急性心肌梗死发生率为6%，对照组为28%。在32例肋软骨炎患者中，分别有3例和2例被诊断为类风湿关节炎和骨关节炎。一年后，21例肋软骨炎患者中有11例（55%）仍有胸痛，但只有三分之一仍有明确的肋软骨炎。
在急诊科环境中，肋软骨炎在胸痛患者中很常见，在女性和西班牙裔中更为频繁。仅少数病例与纤维肌痛有关。肋软骨炎患者急性心肌梗死的发生率似乎较低。大多数病例在1年后可自发缓解。
