Symptoms

The pain in the sternum is perceived as very unpleasant. There is often an additional feeling of pressure or tightness. In most cases the pain itself is stabbing and gets worse when the chest is moved.

When breathing in, it becomes maximal, because the chest is stretched. When breathing out, the pain improves. Affected persons usually breathe shallower in order not to provoke pain.

Mainly because of this breath-dependent pain, there is a fear that the heart or lung system may be diseased. These fears can have an effect on the psyche of the affected person. In rare cases, the sternum may be swollen.

Caution is advised with the following symptoms: The pain in the sternum occurs suddenly and is massive. There is a feeling of tightness in the chest and the pain radiates into the left arm. It is accompanied by paleness, nausea, sweating or shortness of breath.

If this is the case, one speaks of pectanginous complaints. These should be clarified as soon as possible (in an emergency), as they indicate a heart condition. If there is pain in the sternum, the challenge for the initial examiner (usually the family doctor or orthopedist) is to find out whether the cause is external or internal.

In other words, whether the locomotor system or an organ system is the cause. For this purpose, a detailed survey of the symptoms is first carried out. It is important to find out what quality the pain has: whether it is dependent on movement and/or breathing and since when it has been there.

This is followed by a physical examination of the entire thorax. The sternum is inspected and palpated.In addition, the chest and back muscles are also tested to find out if there is any tension in this area. The physical examination also includes listening to the heart and lungs so that cardiac and pulmonary causes of pain can be excluded.

If, after the physical examination, the examiner suspects a disease of the heart or lung system or the esophagus, he will refer the patient to a specialist in these fields. X-rays If a fracture is to be ruled out as a cause of pain, the thorax is X-rayed. X-rays can show the bony structures.

The heart and lungs can also be assessed. For example, pneumonia can be excluded. MRI Magnetic resonance imaging of the sternum is suitable as a diagnostic tool when Tietze syndrome is suspected as the cause of pain. In the case of Tietze syndrome, the X-ray image is inconspicuous. However, the MRI can reveal a swelling of the rib cartilage.