Periosteum inflammation on the ribs

What is periostitis on the ribs?

Periosteum inflammation of the ribs is a rare condition in which the periosteum of one or more ribs is inflamed.
Periosteum inflammation can have various causes, for example an overstrain from persistent coughing or bacterial colonization of the bone membranes, often as part of osteomyelitis (inflammation of the bone marrow) or osteitis (inflammation of the bone).

Causes of periosteum inflammation on the ribs

Periosteum inflammation on the ribs can be caused by mechanical overloading of the chest. A strong cough over a long period of time and excessive strain as part of intensive training can be causes of periosteum inflammation on the ribs.

At the same time, the periostitis can be caused by another inflammation, for example an inflammation of the bone marrow (osteomyelitis) or, less often, osteitis (inflammation of the bone).

Inflammation can be carried away from the respiratory tract. Bacteria and viruses are possible causes of bone inflammation on the ribs and should therefore be excluded from the diagnosis.

Inflammation of the periosteum of the ribs from an accident

An accident can cause all sorts of injuries in the body and cause enormous damage to the ribs. Severe irritation of the periosteum can trigger periosteum inflammation.
At the same time, an accident can encourage the entry of pathogens into the body. Puncture wounds in the chest can cause both bacterial and traumatic periostitis on the ribs.

Read more on the topic: Inflammation of the bone skin on the coccyx

Inflammation of the periosteum of the ribs from coughing

Cough is a symptom that can cause severe discomfort and in some cases lasts for a very long time. A prolonged, heavy cough can cause pleurisy and sore muscles in the rib muscles.
Those affected then feel severe pain in the ribs, especially when coughing or pressing. Pleurisy can spread and cause inflammation of the bones in the ribs.
At the same time, the persistent cough can lead to pronounced mechanical stress on the rib muscles. This means that periosteum inflammation can also result from the tensile forces of the muscles and tendons on the bones and periosteum.

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Symptoms of periosteum inflammation on the ribs

The cardinal symptom of periosteum inflammation on the ribs is pain, which is often described as stabbing and pulling. The pain occurs particularly when the chest is stressed, that is, when coughing and pressing. In some cases, pain is persistent at rest.

Read our article on this: Rib pain when coughing

Depending on the person's body weight, you can occasionally see and feel redness, swelling and warming in the area of ​​the affected chest. The tissue is very painful to pressure and those affected typically adopt a relieving posture.

Periosteum inflammation usually affects several ribs. The symptoms can appear on one or both sides, over the entire chest.

Other possible causes of rib pain

Costal arch pain is a classic symptom of periosteum inflammation on the ribs. Other possible causes are:

  • an intercostal neuralgia
  • a costochondritis
  • pleurisy
  • aching
  • Pulled muscles
  • Broken ribs

Pain in the costal arch requires a thorough diagnosis in order to treat the symptoms specifically, depending on the cause.

Read our article on this: Rib pain - these are the causes

Difference to intercostal neuralgia

Intercostal neuralgia, also known as intercostal neuralgia, is an important differential diagnosis to periosteum inflammation on the ribs. Differentiating the two clinical pictures can be very difficult.
Intercostal neuralgia is typically associated with a dragging, persistent pain in the rib area. The pain can radiate into the chest and / or back in a belt shape. As with periosteum inflammation on the ribs, the pain is aggravated by coughing or pressing movements.

Learn more about the causes, symptoms and treatment options for the Intercostal neuralgia.


To make the diagnosis of periosteum inflammation on the ribs, the doctor first talks to the person concerned about the symptoms and the course of the disease.

This is followed by a physical examination with assessment and palpation of the chest. Tension pain when palpating the affected ribs is typical. In very slim patients, the doctor may notice redness, swelling, and warming of the tissue over the inflamed ribs.

X-ray diagnostics are often carried out to rule out broken ribs, for example.

If a pathogen is suspected as a trigger, a blood count is typically also done.


Treatment for periosteum inflammation on the ribs targets the cause of the inflammation.
If the periostitis is due to excessive exercise, a break in sport with physical rest and pain-relieving, anti-inflammatory medication is indicated. Active ingredients such as ibuprofen or diclofenac are ideal.
A bacterial inflammation of the periosteum on the ribs is treated with appropriate antibiotics.
If the periosteum is a spread inflammation, for example from the pleura or the bone itself, it is extremely important to treat the underlying disease.

Read more on the topic: This is how long periosteum inflammation lasts


The healing time of the inflammation is largely determined by the cause and therapy. The healing time can be weeks to months.

You can find extensive information under our topic: How long does periosteum inflammation last!