Bone Health

Tietze's Syndrome, also known as Costochondritis, is a benign inflammation of one or more of the costal cartilages. Tietze's Syndrome and Costochondritis were initially described as separate conditions, the sole difference being that in Tietze's Syndrome there is swelling of the costal cartilages. It is now recognized that the presence or absence of swelling is only an indicator of the severity of the condition. It was at one time thought to be associated with, or caused by, a viral infection acquired during surgery, but this is now known not to be the case. Most sufferers have not had recent surgery.

Patients with Tietze syndrome develop tenderness and swelling over the ribs and cartilage near the breast bone (sternum). Redness, tenderness, and heat can also be present but a localized swelling is the distinguishing finding. The pain is variable, often sharp, can be confused with heart pain, and can last from hours to weeks. It can cause difficulty with sleeping and even rolling over in bed is sometimes painful. Blood testing (Sedimentation Rate or C-Reactive Protein Test) can show signs of inflammation in patients with Tietze syndrome, whereas patients with costochondritis alone typically have normal tests for inflammation.

Flowers & Wippermann
Synonyms and related keywords: costochondritis, costal chondritis, costochondral joints, costosternal joints, costal cartilage, chest pain, fibrositis, Tietze syndrome
Background In contrast to myocardial ischemia or infarction, costochondritis is a benign cause of chest pain and is an important consideration in the differential diagnosis. Although the term costochondritis often is used interchangeably with fibrositis and Tietze syndrome, these are distinct diagnoses.
Pathophysiology Costochondritis is an inflammatory process of the costochondral or costosternal joints that causes localized pain and tenderness. Any of the 7 costochondral junctions may be affected, and more than 1 site is affected in 90% of cases. The second to fifth costochondral junctions most commonly are involved.

Synonyms and related keywords: chest wall syndrome, costochondral syndrome, costosternal chondrodynia, Tietze syndrome, chest pain, costal chondritis, costochondral joint
Costochondritis is a common cause of chest pain in children and adolescents. The condition is characterized as an inflammatory process of 1 or more of the costochondral cartilages that causes localized tenderness and pain of the anterior chest wall. Most cases of costochondritis are idiopathic. The remaining cases may result from costochondral irritation due to direct trauma, aggressive exercise that caused a strain, or a prior upper respiratory tract infection with cough that caused repeated stretching and strain at the costochondral junction. Costochondritis is a relatively benign and usually self-limited condition. Patients are often evaluated initially in the ED or, with acute conditions, in their primary care physician's office. The term Tietze syndrome implies swelling; costochondritis refers to pain alone.

Tietze's costochondritis may cause or feature chestpain and swelling. "Idiopathic painful nonsuppurative swellings of one or more costal cartilages, especially of the second rib. The anterior chest pain may mimic that of coronary artery disease. (Dorland, 27th ed.)"

Tietze syndrome is a rare, inflammatory disorder characterized by chest pain and swelling of the cartilage of one or more of the upper ribs (costochondral junction). Onset of pain may be gradual or sudden and may spread to affect the arms and/or shoulders. Tietze syndrome is considered a benign syndrome and, in some cases, may resolve itself without treatment. The exact cause of Tietze syndrome is not known.