Cos­to­chon­dri­tis can be caused by ex­er­tion

The Weekend Australian - Travel - - Health - THE DOC­TOR

I have been ex­pe­ri­enc­ing some un­usual left­sided chest pains that worry me. I had a full car­dio check last year which was all clear. A re­cent chest X-ray showed my lungs were okay. Re­cently I picked up my grand­daugh­ter and ex­pe­ri­enced sharp pain in the left ster­num/ribs area. Some­one sug­gested ‘‘ cos­to­chon­dri­tis’’. . . COS­TO­CHON­DRI­TIS is cer­tainly a pos­si­ble di­ag­no­sis. How­ever, if th­ese pains have just re­cently de­vel­oped it would be best to get rechecked for any heart prob­lems. Gen­er­ally speak­ing, chest pain is car­diac un­til proven oth­er­wise. But the na­ture of your symp­toms makes cos­to­chon­dri­tis a more likely di­ag­no­sis. Cos­to­chon­dri­tis is an in­flam­ma­tion of the joint where the rib joins the ster­num. It usu­ally oc­curs as a re­sult of sig­nif­i­cant ex­er­tion, al­though of­ten peo­ple with the con­di­tion can­not re­call a trig­ger­ing event. Some­times the joint will be swollen, and com­monly the area is ten­der to touch and worse with cer­tain move­ments. Time is gen­er­ally the best healer for this con­di­tion, along with avoid­ing any ac­tiv­i­ties that ag­gra­vate the pain. Some­times anal­gesics and per­haps anti-in­flam­ma­to­ries help. I was di­ag­nosed with non-Hodgkins lym­phoma two years ago, had six months of chemo­ther­apy and am now on main­te­nance ther­apy. A cou­ple of years be­fore my di­ag­no­sis, I de­vel­oped some itch­ing on my back, par­tic­u­larly be­tween my shoul­der blades but some­times down to my waist. This itch has per­sisted. I’maware of it all day, ev­ery day and can­not re­late it to cer­tain clothes, tem­per­a­ture, ac­tiv­ity or emo­tional state. Can you sug­gest any ex­pla­na­tion for this prob­lem? ITCH with­out a rash is a rel­a­tively com­mon early symp­tom of lym­phoma. Pos­si­bly more com­mon in Hodgkins rather than nonHodgkins, but cer­tainly it can be a symp­tom of ei­ther. If this is the case, the good news is the itch should re­solve as the lym­phoma treat­ment takes ef­fect and you can take med­i­ca­tions such as an­ti­his­tamines to keep it un­der con­trol un­til it clears. While this is the most likely sce­nario, it might be worth­while check­ing with your doc­tor to rule out any other pos­si­ble causes or other con­tribut­ing fac­tors that might be mak­ing the itch worse. Th­ese could in­clude sim­ple things such as dry skin or med­i­ca­tions you take, or more com­plex prob­lems such as iron de­fi­ciency anaemia, thy­roid or kid­ney dis­ease. My son and daugh­ter-in-law have just found out their 18-month-old daugh­ter has an egg al­lergy. Is this some­thing she will out­grow? AL­LERGY to eggs in chil­dren is very com­mon. Re­search has shown as many as one in 20 chil­dren has an al­lergy to eggs at some stage. Eighty per cent of chil­dren with an al­lergy to eggs out­grow it by the time they turn eight. If your grand­daugh­ter’s orig­i­nal re­ac­tion to eggs was a skin re­ac­tion such as hives or eczema, it is likely than when she is older, her doc­tor will sug­gest she be of­fered eggs again un­der care­fully con­trolled cir­cum­stances. How­ever, if she had an ana­phy­lac­tic re­ac­tion to eggs, it would be un­wise to give her eggs at any stage ex­cept un­der strictest med­i­cal su­per­vi­sion. By the way, skin prick test­ing to see whether she is still al­ler­gic would be of lit­tle help as this of­ten stays pos­i­tive — even though she may no longer de­velop symp­toms when ex­posed to eggs. The other point to make is that while chil­dren com­monly out­grow al­ler­gies to eggs and milk, chil­dren with al­ler­gies to nuts and seafood usu­ally aren’t so lucky. Linda Cal­abresi is a GP and ed­i­tor of Med­i­cal Ob­server. Send your queries to linda.cal­abresi@medobs.com.au

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