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The rib cage flexes during respiration to allow more air to enter than would be the case if it were rigid. Costochrondritis is a condition in which there is pain which is localized in the flexible joints (costochondral junctions) of the rib cage, where the ribs attach somewhat flexibly to the breast bone (sternum). For reasons unknown, adolescents going through puberty seem to be prone to developing inflammation of these joints, often after exercise or a blow to the chest.
The pain may be sharp and sticking at first, but it usually becomes a dull aching pain. The most common sites of this pain are where the left fourth and fifth ribs attach to the sternum. This is right in the area of the heart, and therefore can create a good bit of anxiety in both the child and the parents.
The key to diagnosis is that the pain can be reproduced by pressing on the involved area of the chest wall. This pain is not as sharp and intense as that of a rib fracture (which might be considered if there is a history of a blow to the chest).
The treatment of costochondritis is anti-inflammatory medicine such as ibuprofen or naprosyn.