Tietzes Syndrome

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Tietzes Syndrome is an inflammation of the costochondral cartilages. It is characterized by swelling of one or more costal cartilages causing pain that may radiate to the neck, shoulder, or arm and mimic the pain of coronary artery disease.

Patients with Tietze syndrome develop tenderness and swelling over the ribs and cartilage near the breast bone. 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 can show signs of inflammation in patients with Tietze syndrome, whereas patients with costochondritis alone typically have normal tests for inflammation.


    Most patients with Tietze's Syndrome experience pain over the front of the upper chest. Because of serious conditions, most importantly conditions related to heart problems, Tietze's syndrome should only be diagnosed after excluding other more serious problems.
    Tietze's syndrome pain is usually worsened by activity or exercise. Often the pain is worsened when taking a deep breath. This stretches the inflamed cartilage and can cause significant pain. Touching the area involved by Tietzes syndrome can be extremely painful for the patient.
    Because of the many nerves that branch away from the chest, pain may be experienced in the shoulder or arms as well. The pain from Tietze's syndrome is accompanied by redness and or swelling in the areas most tender.

It is often difficult to indentify a single cause of Tietze's syndrome. This condition is thought to be commonly due to repetitive microtrauma, or overuse. This means that activities are causing repeated damage to the cartilage of the chest wall leading to inflammation. The most frequently affected age group is young adults between 20 and 40 years old. Tietzes syndrome can also been found as an overuse injury in athletes, in particular this condition has been identified in competitive rowers.

Tietze's syndrome can also be found after a traumatic injury. For example, a car accident where the driver's chest strikes the steering wheel can cause Tietze's syndrome by injuring the ribs and cartilage on the front of the chest. Viral infections, usually upper respiratory infections, have also been identified as a cause of Tietze's syndrome.

Tietze's syndrome usually responds well to some simple treatment steps. It is helpful is the cause of costochondritis can be determined, and any activities that may have led to the inflammation can be avoided.

  • Rest In order to decrease the inflammation, you will have to avoid activities that cause pain and exacerbation of the costochondritis. Exercise, deep breathing, and strain on the muscles of the chest may worsen the symptoms of pain and slow the healing process. As a general rule of thumb, avoid or limit activities that worsen your symptoms.
  • Heat Applications Applying hot packs to the chest can be helpful in relieving symptoms of costochondritis. Apply heat several times each day, especially before activities that may irritate your symptoms. While ice application can hep with most conditions of inflammation, applying ice to the chest can be quite uncomfortable.
  • Anti-Inflammatory Medications Nonsteroidal anti-inflammatory medications (e.g. Motrin, Advil) help with two aspects of Tietzes syndrome. First, they help decrease symptoms of pain making patients more comfortable. Second, these medications help to decrease inflammation, which is the primary problem. Check with your doctor before taking anti-inflammatory as they have potential side effects.
  • See Your Doctor While these symptoms usually improve within a few weeks, and resolve completely within a few months, there are patients in whom this problem persists for some time. See your doctor to ensure nothing more serious is going on. Occasionally, Tietze's syndrome will be treated with cortisone injections, but this must be discussed with your doctor.

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