Non-traumatic costochondritis, which manifests as pain and tenderness over the anterior chest wall, may be associated with inflammatory arthritis affecting the upper costochondral and sternocostal joints. Local corticosteroid injection is helpful for recalcitrant cases and ultrasound guidance may not be routinely used by experienced rheumatologists. We report a female patient with pain over the right upper parasternal area with gradual swelling near the first costosternal junction. The ultrasound examination revealed a hyper-vascular mass, which was proven to be Hodgkin's lymphoma. We want to emphasize the importance of using ultrasound for guiding injection for costochondral lesions which facilitated the detection of a tumor invading the chest wall in our case.