The exact pathophysiology of cartilage and capsular involvement is unknown because costochondritis does not warrant surgical intervention or tissue biopsy. Theoretically, the cartilage involved in costochondritis is either inflamed or torn. Either condition presumably leads to inflammation with subsequent stimulation of pain receptors. A study indicates Hispanics may have a higher incidence of costochondritis, but most studies do not mention race as a factor. The key to the diagnosis of costochondritis amid the differential diagnoses, which include cardiac and pulmonary disease, is a thorough history and physical examination.
Vital signs are important.
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.