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Perichondritis
1Accident and Emergency Department, Royal Liverpool Children's Hospital (Alder Hey).
Insights
Costochondral pain in children is often misdiagnosed, leading to unnecessary tests. Accurate history and examination are key for correct diagnosis and effective treatment with medication or injections.
Area of Science:
- Pediatric Gastroenterology
- Pediatric Rheumatology
- Pain Management
Background:
- Costochondral pain, an inflammation of cartilage connecting ribs to the breastbone, can present as abdominal pain in children.
- Misdiagnosis of pediatric abdominal pain leads to delayed treatment and increased healthcare costs.
Observation:
- Five pediatric cases of abdominal pain attributed to costochondral origin were reviewed.
- Four out of five children experienced initial misdiagnosis, resulting in unnecessary investigations and inappropriate treatments.
Findings:
- Accurate patient history and thorough physical examination are crucial for diagnosing costochondral pain.
- Mefenamic acid proved effective for most cases, while one child required methylprednisolone injection.
Implications:
- Emphasizes the importance of considering costochondral pain in pediatric abdominal pain differential diagnoses.
- Highlights the need for physician education on recognizing and managing this condition to avoid diagnostic delays and reduce healthcare expenditures.
Abstract:
5 children with abdominal pain of costochondral origin were seen between October, 1987, and February, 1988. 4 were initially misdiagnosed and had unnecessary and costly investigations and inappropriate treatment. An accurate history and a thorough examination are essential to reach the correct diagnosis. A short course of mefenamic acid was effective in all but one child, who responded to a local injection of methylprednisolone.