In a series of 320 consecutive patients referred because of precordial pain, the costosternal syndrome was found to be the underlying cause in 21, while in nine others, this syndrome was found to be coexisting with coronary heart disease. In our opinion, because of the current readiness to diagnose coronary artery disease, local causes for chest pain often are overlooked. The frequency of this syndrome is relatively high, both as a sole cause of chest pain and combined with coronary artery disease. Local injection of steroids was followed by improvement in the majority of our patients.
(Arch Intern Med 136:189-191, 1976)
Wolf E, Stern S. Costosternal SyndromeIts Frequency and Importance in Differential Diagnosis of Coronary Heart Disease. Arch Intern Med. 1976;136(2):189–191. doi:10.1001/archinte.1976.03630020043010