Premature Calcification of Costochondral Cartilage: A Scoping Review of the Literature

Premature costochondral calcification is a rare finding occurring in young patients and is associated with metabolic and endocrinological conditions. Significant heterogeneity exists with regard to its definition and assessment. This scoping review aimed to summarize the prevalence, risk factors, etiology, evaluation, and management of patients with premature costochondral calcification. A scoping review was conducted in PubMed, Embase, CINAHL, CENTRAL, Scopus, and Web of Science, as well as grey literature databases, including OpenGrey and Google Scholar up to 7 December 2024 in accordance with the PRISMA for Scoping Reviews (PRISMA-ScR) checklist. Keywords related to premature calcification of costochondral cartilage were used for the literature search. A narrative review of the prevalence, risk factors, etiology, evaluation, and management of patients with premature costochondral calcification was presented. Of 152 citations, 52 articles were included in this review. Premature costochondral calcification was defined as radiological findings of costochondral cartilage calcification in a patient aged 40 years old or less. The prevalence of premature costochondral cartilage calcification ranges from 0% to 100%, with increasing incidence with age. Common conditions associated with premature costochondral cartilage calcification include hyperthyroidism, trauma/fracture, familial chondrocalcinosis, malignancy, porphyria, and Tietze syndrome. Risk factors associated with premature costochondral calcification include older age, female gender, and history of menstrual disorders. Recommended workup for premature costochondral calcification includes thyroid panel, serum calcium and phosphate, renal profile, liver profile, and vitamin D levels. Premature costochondral calcification remains a radiological finding that warrants careful medical assessment given its association with multiple pathological conditions. More research is required to understand its underlying pathophysiology, optimal initial assessment, and follow-up.