COSTOCHONDRAL CARTILAGE INJECTION,PROCEDURE PREPARATION:,  After being explained the risks and benefits of the procedure, the patient signed the standard informed consent form.  The patient was placed in the supine position.,Intravenous access was established.  The patient was given mild narcotics for sedation.  For further details, please refer to anesthesia note.,DESCRIPTION OF PROCEDURE:,  The area of discomfort was palpated under fluoroscopy and the costochondral cartilages that were symptomatic were marked out.  After careful asepsis, local anesthesia was given subcutaneously and a 0.25-gauge hypodermic needle was inserted into the costochondral cartilage junction, taking care not to stray from the rib.  Fluoroscopy in AP and lateral positions confirmed good position of the needle in the * costochondral junction and subsequently after aspiration, 0.5 mL of Depo-Medrol 80 and 0.5 mL of 0.5% Marcaine was injected.  The same procedure was carried out at the * costochondral junction.,POSTPROCEDURE INSTRUCTIONS:,1.  After a period of 30 minutes of observation, during which there was no distress and good relief of symptoms was noted, the patient was discharged home.,2.  The patient has been given instructions on watching for possible pneumothorax and any respiratory distress.  The patient will call us if any inflammation, swelling, or other associated discomfort arises.  We will call the patient in 48 hours.pain management, costochondral cartilage injection, 0.5% marcaine, ap and lateral, costochondral, depo-medrol, costochondral junction, fluoroscopy, hypodermic needle, pneumothorax, subcutaneously, supine position, cartilage injection, costochondral cartilage, needle, distress, cartilage, injection,