Costochondritis and thoracic-chest related pain: a scoping review

Abstract:
Background: Costochondritis is a frequent diagnosis related to chest pain but the etiology, treatment, and evolution of the disease are poorly documented. Clinical examination lacks specificity and most treatment recommendations are conservative in nature and have been traditionally accepted, perhaps because of the self- limited nature of the condition. However, costochondritis that does not self-resolve is referred to as atypical costochondritis and is associated with high medical expenses and psychological burden on the patient. This scoping review will aim to provide a clear overview about costochondritis, including definitions and terms, signs and symptoms, causes, diagnosis, treatment and prognosis. This work will also aim to propose shareable terms to describe this condition. Inclusion Criteria: Every study describing a condition of non-cardiac musculoskeletal chest pain due to inflammation of the costochondral junctions of ribs or costosternal joints where the areas of tenderness are not generally accompanied by heat, erythema or localized swelling (e.g.,Tietze syndrome). This scoping review will consider studies conducted in any context. Articles in English or Italian will be considered. Methods: The proposed scoping review will be conducted in accordance with the Joanna Briggs Institute methodology (JBI) for scoping reviews. The search will be carried out on 5 databases: MEDLINE, Embase, Cochrane Library, CENTRAL and CINAHL. Addictionally, research protocols will be searched on PROSPERO and ClinicalTrials.gov. Further research of grey literature will be carried out through OpenGrey and Google Scholar. Selection and data extraction will be conducted by two blind independent researchers and inconsistencies will be resolved by a third reviewer. The results will be presented in a schematic, tabular and descriptive format that will line up with the objectives and scope of the review. Conclusions: This scoping review will aim to provide a comprehensive overview of the topic. The results will add meaningful information for clinicians. Furthermore, any knowledge gaps of the topic will be identified.