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- Tue Nov 04, 2008 1:42 am
I have a lump in the xiphoid process that doctors say is cartiledge build up that grows every year. It started as a quarter size 4 yrs ago and is now the size of a small fist. I have extreme pain when I swallow pills or when I eat. Have seen every kind of doctor (primary, endo, gastro, surgeon, pulmonologist, physiatrist) short of a brain surgeon. No one seems to think it is serious and dismisses me after the appointment.
Can anyone assist with what may be going on or recommend what kind of doctor to see next?
| Dr. Safaa Mahmoud
- Tue Nov 25, 2008 6:13 pm
It is difficult to tell what this swelling could be without a thorough clinical history, direct clinical examination and investigations.
It sounds like Tietze syndrome which is an inflammation of the costochondral cartilages of the upper front of the chest.
Swelling, pain and tenderness over the ribs and cartilage over sternum are the main symptoms. A localized swelling is characteristsic.
The pain can be so distressing and may mimic pain of cardiac origin.
Elevated ESR or C-reactive protein test are common in patients with Tietze syndrome due to inflmmation.
The main stay of treatmetn is rest, anti-inflammatory drugs, and physiotherapy. Cortisone injection shots may be needed in severe inflmmatory changes as well as local applicants of Ice pack. Local analgesic patch may be needed to control the pain.
Cartilage excision may be considerd when all measures fail and should be discussed with an orthopedic surgeons.
Other causes like cartilage or bone tumors or soft tissue masses should be excluded.
Hope you find this information useful.
I would advise you to follow up with your doctor and to update him with your symptoms.
Please keep us updated.