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#223390 - 12/15/11 10:51 AM Pleurisy vs. Costochondritis
ljohnsy Offline
Registered Visitor

Registered: 11/17/09
Posts: 302
Loc: Washington, D.C.
Can someone help me understand the differences between these conditions, specifically where the pain is felt?

Thanks.
_________________________
Laura -- age 36, diagnosed with AS 11/09. Mom of 2. Currently taking Humira.

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#223393 - 12/15/11 12:02 PM Re: Pleurisy vs. Costochondritis [Re: ljohnsy]
sequoia
Unregistered


sure laura. i have had both dxs - in the case of true pleurisy only about 3 times. in the case of costochondritis, on-going.

costo is inflammation (part of the AS enthesitis process) of the ribs where the tendons attach to the sternum. it hurts right were you feel your breastbone (sternum). the inflammation process results (at least for me) with swelling and pain across the upper part of the chest (starting up close to the base of the neck and down the center a few inches). on my bone scan, as a result of the enthesitis process, my whole sternum and all of the attachments are black with contrast.

now for pleurisy. it HURTS to breathe. as your lungs inflate, the lining of the pleural cavity (the lining of the outside of the lungs in the cavity) is stretched due to breathing and the pain is excruciating when you breathe. i will check to confirm if the pleurisy is actual bacterial caused as i believe when i had it. i took antibiotics and was healed in a couple of weeks. i did bind my ribs with an ace bandage to limit the depth of my breathing for the short time (day or two) based on docs orders, and to relieve the pain. this is an old school treatment, but it works.

in my experience the costo is ongoing. the pleurisy is occasional. the pleurisy is extremely painful. i just live with the costo pain.

hope it isn't too much info, but that this helps, laura...

prayers and peace, sequoia

pleurisy is both bacterial or viral


Edited by sequoia (12/15/11 12:05 PM)

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#223398 - 12/15/11 01:24 PM Re: Pleurisy vs. Costochondritis [Re: ]
JoelinWA Offline
Registered Visitor

Registered: 11/19/11
Posts: 21
Loc: WA
Good explaination Sequoia. I also have dxs of both costo and pleurisy. Pleuisy can also be caused by autoimmune action [inflammation due to the immune system killing cells of the lung lining, causing inflammation of the lining] (as I have), but others can have it caused by bacterial or viral reasons.

For me, the TNF blockers relieved 100% of my pleurisy! smile But when I stop the anti-TNF meds (or they stop working) it comes right back.

I am very grateful for the anti-TNFs (and the scientists that invented them)!
Joel

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#223403 - 12/15/11 03:00 PM Re: Pleurisy vs. Costochondritis [Re: JoelinWA]
sequoia
Unregistered


the autoimmune involved is the disease (dx) like RA or lupus. the pleurisy is a complication of that dx. i don't think it can exist as a stand alone autoimmune, at least i haven't read as such. however, i will keep looking. at very least, if RA can cause it, i would not be surprised if it could be a complication of AS, tho rare.


thanks, s.

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#223413 - 12/15/11 06:12 PM Re: Pleurisy vs. Costochondritis [Re: ]
ljohnsy Offline
Registered Visitor

Registered: 11/17/09
Posts: 302
Loc: Washington, D.C.
Thanks to both of you. I thought I had costo based on what I read but today my dr. said he thinks it may be pleurisy because my pain is only in my rib area on one side, not chest, or sternum or spine. Every night it hurts when I take deep breaths. All of my other symptoms are worse at night too...

I thought pleurisy was a sporadic condition but I've had this pain consistently for months.

Anyway, thanks for the info.

_________________________
Laura -- age 36, diagnosed with AS 11/09. Mom of 2. Currently taking Humira.

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#223416 - 12/15/11 07:21 PM Re: Pleurisy vs. Costochondritis [Re: ljohnsy]
avonldy Offline
Registered Visitor

Registered: 12/14/09
Posts: 2466
Loc: N. Sacramento Valley
I used to get pleurisy whenever it was foggy. For a short time, we would drive out to the desert and stay for a few days and I would get better right away. A change of climate never helped my Costo. Costco usually hurts if you press on your breastbone, pleurisy hurts to take a deep breath. Sequoia gave a good explanation.
_________________________
Donna
Suffering since a teenager.Dx with AS Dec 2009. Dx with ulcerative colitis 1998, both knees replaced 2006. GP said I had "some kind of inflammatory arthritis" 25 years ago. It has taken 50 years to get a Dx.

Mobic, Nexium, Naproxin, Lipitor, 6-MP, Nexium, Miacalcam, MSContin and 2 Norco for break through pain

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#223432 - 12/16/11 05:03 AM Re: Pleurisy vs. Costochondritis [Re: avonldy]
Roqufort Offline
Registered Visitor

Registered: 05/28/08
Posts: 1162
Loc: Texas
I just had this conversation with my rheumy this week. when I had costo, the pain was near the lower part of my chest ribs, low enough for the dr to be concerned for my gall bladder. right now, It is higher, closer to the lower part of hte shoulder blade and on the side. dr said its pleurisy because of the location. treatment is the same for me, and the pain (although in a dif location) is the same when I breathe deeply.


_________________________
Carrie
Retired Navy Wife, 43 / mother of 5, Fort Worth, Texas
Remicade, Norco, lunesta, buspar, Folic Acid, MTX

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#223443 - 12/16/11 07:35 AM Re: Pleurisy vs. Costochondritis [Re: Roqufort]
sequoia
Unregistered


carrie, and all, i am just posting this because i had felt pain elsewhere on/in my ribcage in the past, but apparently the real costo - as opposed to inflammation in general, is supposed to be where the ribs meet the sternum. i believe we can have rib pain for the simple reason that we have intercostal muscles between the ribs and, of course, tendons which attach them to the ribs. carrie, i wonder if you did have pleurisy when it was where your gall bladder is.


from the mayo clinic site:

Illustration of rib cage showing the ribs, the breastbone and the costosternal joints Bones and joints associated with costochondritis

Costochondritis (kos-toe-KHON-dri-tis) is an inflammation of the cartilage that connects a rib to the breastbone (sternum). It causes sharp pain in the costosternal joint where your ribs and breastbone are joined by rubbery cartilage. Pain caused by costochondritis may mimic that of a heart attack or other heart conditions.

just for clarity, and also that everyone gets checked out for pain elsewhere, especially if it hurts, could be the pleurisy. which can be treated by antibiotics and antivirals, in most cases.

good luck everyone, these two conditions are very painful and seem to crop up quite a bit.

s.

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#223469 - 12/16/11 10:03 AM Re: Pleurisy vs. Costochondritis [Re: ]
Roqufort Offline
Registered Visitor

Registered: 05/28/08
Posts: 1162
Loc: Texas
seq, it could have been, the pain was so far reaching, what i have now, is not tender to touch, but before it was. guess thats why rheumy said costo before and pleurisy now... HUGS
_________________________
Carrie
Retired Navy Wife, 43 / mother of 5, Fort Worth, Texas
Remicade, Norco, lunesta, buspar, Folic Acid, MTX

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#223470 - 12/16/11 10:04 AM Re: Pleurisy vs. Costochondritis [Re: ]
avonldy Offline
Registered Visitor

Registered: 12/14/09
Posts: 2466
Loc: N. Sacramento Valley
One thing that my GI pointed out to me is that we have cartilage around/between our ribs. He was examining me one day and I winced when he probed the area near the bottom of my ribs. He said that the cartilage was inflamed. I have noticed that same tenderness on several occasions. He seemed to think it was all part of the IBD/arthritis problem. He and my GP both lump all my problems into one condition.
_________________________
Donna
Suffering since a teenager.Dx with AS Dec 2009. Dx with ulcerative colitis 1998, both knees replaced 2006. GP said I had "some kind of inflammatory arthritis" 25 years ago. It has taken 50 years to get a Dx.

Mobic, Nexium, Naproxin, Lipitor, 6-MP, Nexium, Miacalcam, MSContin and 2 Norco for break through pain

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