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Chondritis is inflammation of cartilage.
It takes several forms, osteochondritis, costochondritis, Relapsing polychondritis among them. Costochondritis is notable for feeling like a heart attack.
Inflammation occurs in the laryngeal, tracheal and bronchial cartilages. Both of these sites are involved in 10% of persons with RP at presentation and 50% over the course of this autoimmune disease, and is more common among females.
The involvement of the laryngotracheobronchial cartilages may be severe and life-threatening; it causes one-third of all deaths among persons with RP.
Laryngeal chondritis is manifested as pain above the thyroid gland and, more importantly, as dysphonia with a hoarse voice or transient aphonia. Because this disease is relapsing, recurrent laryngeal inflammation may result in laryngomalacia or permanent laryngeal stenosis with inspiratory dyspnea that may require emergency tracheotomy as a temporary or permanent measure.
Tracheobronchial involvement may or may not be accompanied with laryngeal chondritis and is potentially the most severe manifestation of RP.
The symptoms consist of dyspnea, wheezing, a nonproductive cough, and recurrent, sometimes severe, lower respiratory tract infections.
Obstructive respiratory failure may develop as the result of either permanent tracheal or bronchial narrowing or chondromalacia with expiratory collapse of the tracheobronchial tree. Endoscopy, intubation, or tracheotomy has been shown to hasten death.
Involvement of the rib cartilages results in costochondritis. Symptoms include chest wall pain or, less often, swelling of the involved cartilage. The involvement of the ribs is seen in 35% of persons with RP but is rarely the first symptom.
Breast pain is a medical symptom that is most often associated with a developing disease or condition of the breast. These are usually benign breast diseases or conditions such as mastalgia, mastodynia, and fibrocystic breast changes. These disorders are painful and associated with lumps. Some breast pain is normal and associated with the changes that accompany puberty, pregnancy, lactation and menopause. The pain can be in one breast or both. The pain may constant, cyclical, or present only on palpation or when it is touched.
Ruling out the other possible causes of the pain is one way to differentiate the source of the pain. Breast pain can be due to:
- angina pectoris
- anxiety and depression
- bra
- blocked milk duct
- breastfeeding
- chest wall muscle pain
- consensual, rough sex
- costal chondritis (sore ribs)
- cutaneous candida infection
- duct ectasia (often with nipple discharge)
- engorgement
- fibroadenoma
- fibrocystic breast changes
- fibromyalgia
- gastroesophageal reflux disease
- herpes infection
- hormone replacement therapy
- mastalgia
- mastitis or breast infection
- menopause
- menstruation and Premenstrual syndrome
- perimenopause
- neuralgia
- pregnancy
- physical abuse
- pituitary tumor (often with nipple discharge)
- puberty in both girls and boys
- sexual abuse
- shingles
- sore nipples and cracked nipples
- surgery or biopsy
- trauma (including falls)
Medications can be associated with breast pain and include:
- Oxymetholone
- Chlorpromazine
- Water pills (diuretics)
- Digitalis preparations
- Methyldopa
- Spironolactone
Diagnostic testing can be useful. Typical tests used are mammogram, excisional biopsy for solid lumps, fine-needle aspiration and biopsy, pregnancy test, ultrasonography, and magnetic resonance imaging (MRI).