Tietze's syndrome

Overview
Tietze's syndrome, also known as costochondritis, is a benign inflammation of one or more of the costal cartilages. It was first described in 1921 by the German surgeon Alexander Tietze (1864-1927).

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.

It should not be confused with Tietz syndrome.

Presentation
The primary presentation of the syndrome is significant, acute pain in the chest, along with tenderness and some swelling of the cartilages affected, which is commonly palpable on examination. Although many times it can be extremely painful, to the point of being debilitating, Tietze's Syndrome is considered to be a benign condition that generally resolves in 6-8 weeks. Perceived pain is often exacerbated with respiration.

Costochondritis symptoms are similar to the chest pain associated with a heart attack.

If the pain does not completely cease within two months, the patient must consult a doctor.

Cause
While the true causes of Tietze's Syndrome are not well understood, it often results from a physical strain or minor injury, such as repeated coughing, vomiting or impacts to the chest. It has even been known to occur after hearty bouts of laughter. It can occur by over exerting or by an injury in the chest.

Differential diagnosis
Although patients will often mistake the pain of Tietze's Syndrome for a myocardial infarction (heart attack), the syndrome does not progress to cause harm to any organs.

Doctors often reassure patients that their symptoms are not associated with a heart attack, although they may need to treat the pain, which in some cases can be severe enough to cause significant but temporary disability to the patient.

There is pain and discomfort in the chest wall of the patient. The pain is generally at night and in the morning. The pain subsides in five to six hours. The patient must not move or exert during pain. The patient should lie down and lightly massage the affected area.