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Are you on any medications?
What are the investigations done?
Is there any tender point (pain on pressing)?
What are the treatment done?
A consideration of costochondritis can be done, which is inflammation at the junctions of rib and cartilage or with the breast bone. Anti-inflammatory analgesics (Ibuprofen), local analgesic ointment, or spray, chest brace and warm compresses are helpful in this. Though, with a hiatus hernia, one has to be careful with the analgesic and has to be give with the acid blockers. Read about the costochondritis, in this resource;
A chronic costochondritis also respond to the deep electrotherapy (done at physical therapy centers) like TENS (trans cutaneous electrical stimulation), phonophoresis and iontophoresis.
Polychondritis is another diagnosis and sometimes this may be associated with raised counts or abnormalities of the metabolic panel. If your echocardiography has not been done, it should be done to rule out pericarditis, with your clinical manifestations and history of enzyme changes related to the liver and pancreas. Pleurodynia would be the another possibility. Tietze's syndrome should be considered in the differential diagnosis, which is characterized by nonsuppurative edema (swelling).
Please feel free for your follow up questions.
Pulmonolgist, or any physician unless, looking for the costochondritis specifically will miss it. He is otherwise also looking and hearing for the lung pathologies. Polychondritis is an immune mediated condition and can involve some organs with it. This occurs is differing severity in an individual. In your case it is not likely but is an important consideration to look for it in ongoing symptoms for so long. Read about it;
Pleurodynia is an illness characterized by fever and paroxysmal spasms of the chest and abdominal muscles. This is caused by group B coxsackieviruses.
Mild hiatal hernia is not likely to be related to your manifestations.
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Your primary health care provider is the best to diagnose the costochondritis, if you are comfortable with him. Otherwise go to an orthopedist to rule out or rule in this diagnosis. If this is the diagnosis, it is not difficult to treat. If it is not, consult an internist for an evaluation for heart and pericardium (covering of the heart) and to look for other chest diseases.
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