Thursday, January 27, 2011

Can you get RA in your Ribs?!

I've had my JRA since I was 3, it started in my left knee, but by the time I was 8 it had spread throughout my entire body.  I think the oddest place that I've had my RA pain, are my ribs.  I wasn't sure if you could even get RA in the ribs, so I decided to do some research about this.  I also emailed my Rheumatologist, asking him if you could get RA in the ribs.  Here is his response:

Hi Mallory,
RA affects joints (connections between bones) and only certain kinds of joints (the ones that we call synovial joints). Ribs and their connections to the spine in the back or the sternum (breast bone) in the front are usually not affected. However, pleurisy (inflammation in the space between the inside of the chest wall and the lungs) is is not uncommon in RA and is experienced as pain of the chest wall. This pain may seem to come from the ribs but really comes from the inside of the chest. Not sure whether this is what you had but it is possible. Does that make sense ?
Best,
JE

So, it seems that RA itself does not affect the ribs directly.  In doing research I found that rib pain can be associated with Pleurisy, as my rheumy stated and also Costochondritis. 

Pleurisy is also known as pleuritis, is a condition that results from the swelling of the linings of the lungs and chest. The pleural cavity (area between lungs and inner chest wall) is created by two lubricated surfaces called pleura, the inner pleura lining the lungs and the outer lining the chest wall.  Pleurisy is a common complication of several different medical conditions, the most pervasive being a viral infection of the lower respiratory system.  It can also be affected by autoimmune diseases like Lupus or RA. The main symptom of pleurisy is a sharp, stabbing pain in the chest. This pain can affect the shoulders and back as well, but is often on one side of the chest only. A person with pleurisy will sneeze, cough, and exercise shallow breathing due to the pain caused by deep breathing.

Costochondritis is a condition that causes chest pain due to inflammation of the cartilage and bones in the chest wall. Also called Tietze's Syndrome, costochondritis occurs when there is inflammation at the junction of the rib bone and breastbone (sternum). At this junction, there is cartilage joining these bones. This cartilage can become irritated and inflamed. Depending on the extent of the inflammation, costochondritis can be quite painful. Most patients with costochondritis experience pain over the front of the upper chest (the area of the sternum). Because of serious conditions, most importantly conditions related to heart problems, costochondritis should only be diagnosed after excluding other more serious problems. Costochondritis pain is usually worsened by activity or exercise. Often the pain is worsened when taking a deep breath. This stretches the inflamed cartilage and can cause significant pain. Touching the area involved by costochondritis can be extremely painful for the patient. Because of the many nerves that branch away from the chest, pain may be experienced in the shoulder or arms as well. When called Tietze's Syndrome, the pain from costochondritis is accompanied by redness and or swelling in the areas most tender.

So in conclusion, it seems that rib pain is not associated RA directly, but there could be an underlying cause.  Costochondritis and Pleurisy can both be associated with RA.  If you are having chest pain at all, please contact your doctor because you never know what could be causing it. 

6 comments:

  1. very painful i must confess. is there any cure?

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  2. Hi Mallory, hope you are keeping well. I found your info on Costochondritis very interesting. I have been having chest pain for 3 weeks or so and following a second visit to my Dr. was diagnosed with this problem. I am 74 yrs old, and touch wood in reasonable health, but was quite worried as to what was causing this pain. I've been told to take painkillers, apply some heat (wheatbag) and it will eventually clear up.

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  3. I have become desperate after 4 years of giving birth to my daughter, iv suffered more rib pain and bruising like feeling when press on the ribs, back and front, and have a sharp pressure chest pain sometimes, could this be arthritis, im being refered to the metabolic bone clinic next month see if they can help me.

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  4. to anonymous...what happened with your bone clinic visit and your pain in ribs?

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  5. IM HAVING PAIN IN RIGHT MID RIB SECTION.. I GET SOME RELIEF WITH ADVIL.. I HAD INJURY TO RIBS SEVERAL YEARS AGO. COULD IT BE ARTHRITIS?

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