Inspection focuses on symmetry of the chest wall. Asymmetry may indicate trauma as a cause of chest pain. Swelling is uncommon. Patients with Tietze syndrome, however, may have swelling over an upper costochondral junction. Ecchymosis would be expected only in trauma.
Respiratory effort is normal.
Palpation that reveals tenderness over the costochondral junction is diagnostic. The tenderness should be localized and is most common at the sternocostal cartilage of the second through the seventh ribs. Examination may be performed with firm, single-digit palpation of the area. Crepitus is uncommon and may indicate a fracture. Auscultation of the lungs, heart, and abdomen are normal.