Tietze Syndrome - Symptoms, Causes, Diagnosis, Treatment

Introduction

Tietze syndrome is categorized as a rare disease of the musculoskeletal system. It affects the cartilage of the upper ribs. The patient experiences pain in the upper ribs but not to a severe extent. There are two synonyms of Tietze syndrome, namely- chondropathia tuberosa and costochondral junction syndrome. Tietze syndrome is a kind of inflammatory condition that causes swelling of the cartilage of the upper rib cage and, thus, pain. The pain occurs in a specific location, generally the sternum or the breastbone. The pain tends to radiate to the arms as well as the shoulders. The pain is either sudden or gradual in onset. Tietze syndrome does not require any specific treatment because it may disappear on its own and thus is considered to be a benign condition. The root cause of Tietze syndrome remains unknown.

What Are the Signs and Symptoms of Tietze Syndrome?

The clinical manifestations of Tietze syndrome vary from person to person. Nevertheless, some signs and symptoms may be present in most cases of Tietze syndrome.

Mentioned below are a few of the signs and symptoms of Tietze syndrome.

• Tietze syndrome has a classical pain that is mild to severe around the upper ribs.

• The second rib and the third rib ache the most amongst the majority of the suffering individuals.

• The cartilage of either rib gets affected, not both ribs.

• The pain follows a route that forms a spindle shape.

• Swelling the cartilage leads to a firm, sharp, gripping, and dull pain that simulates neurological discomfort.

• The ache radiates to the arms, neck, and shoulders and may cause warmth and redness throughout the pain pathway.

• The intensity of the pain is sudden but may also be gradual.

• Sneezing, strenuous activity, vigorous exercise, and coughing may stimulate the pain.

• Even if the swelling remains in the cartilage, the pain gradually decreases after a few weeks or months.

• The swelling is palpable in almost all cases of Tietze syndrome.

• Individuals also complain of feeling like a knife stabbed into the bone when the pain arises.

What Are the Causes of Tietze Syndrome?

Tietze syndrome is idiopathic. Idiopathic refers to a condition that has no definitive cause for its development. Thus there is no well-defined reason and cause for Tietze syndrome.

Mentioned below are a few of the causes of Tietze syndrome.

• Microtrauma of the upper rib cage or upper body has been speculated to be one of the causes of Tietze syndrome, but this is not yet established nor proven.

• The disturbance of the anterior chest wall is another hypothetical cause of Tietze syndrome.

• Diseases with clinical manifestations such as long-standing cough, nausea, vomiting, viral infections, or bacterial infections may also cause Tietze syndrome.

• Surgery in the thoracic area that may be quite invasive, trauma to the chest, or heavy impact to the chest that is continuous are associated with the development of Tietze syndrome.

• Nevertheless, none of the above-mentioned reasons are definite and thus are just researched causes that still require deeper study and establishment.

Who Are Affected With Tietze Syndrome?

Tietze syndrome is known to affect any age group, but particular age groups are highly prone to be affected with Tietze syndrome. In most cases, males and females in their third and fourth decades of life develop Tietze syndrome. Young adults and older individuals risk developing Tietze syndrome more than smaller age groups. Rarely has Tietze syndrome been diagnosed and documented in infants and children. There is no discrepancy in gender, and thus Tietze syndrome affects males and females similarly.

How to Diagnose Tietze Syndrome?

Clinical evaluation and thorough family history are the first steps to diagnosing rare diseases such as Tietze syndrome. A detailed understanding of the patient's medical history and clinical manifestations, including the signs and symptoms, should also be discussed and understood. Several tests help in the diagnosis of Tietze syndrome.

Mentioned below are a few of the diagnostic tools that aid in the detection of Tietze syndrome.

• Electrocardiogram.

• X-rays of the chest.

• Palpating the chest wall.

• Magnetic resonance imaging of the chest.

• Biopsy.

How to Treat Tietze Syndrome?

In most cases, Tietze syndrome and its signs and symptoms disappeared over time. Additionally, it should be noted that Tietze syndrome does not have an established and well-studied permanent treatment strategy. One of the reasons for this is the scanty nature of the disease. Nevertheless, a patient undergoing pain and several other symptoms of Tietze syndrome may gain some relief due to a few therapeutic plans.

Mentioned below are a few treatment modalities of Tietze syndrome.

• Rest.

• Avoid vigorous exercise.

• Heat application on the area of pain.

• Over-the-counter medication for pain relief.

• Avoiding strenuous activities.

• Analgesics.

• Corticosteroids may be administered locally.

• Injection-safe anesthetic such as lidocaine.

• Massaging of the painful areas.

Conclusion

Tietze syndrome refers to a rare disease that affects the musculoskeletal area. Tietze syndrome occurs when the cartilaginous tissue around the bone or joints gets inflamed. This inflammation is mostly seen in the upper ribs and sternum. The second and the third rib are affected in most cases. The exact cause of Tietze syndrome remains unknown. Trauma is believed to be one of the reasons that may hypothetically cause the development of Tietze syndrome. Respiratory conditions, vigorous fits of continuous coughing, and strenuous activity are other expected causes of Tietze syndrome. It has also been believed that psoriatic arthritis may likely cause Tietze syndrome. Tietze syndrome is not a serious condition but can be painful. Tietze syndrome disappears on its overtime, and thus Tietze syndrome does not require nor does it have any particular treatment modality.