Complications
Tietze syndrome is an inflammatory condition characterized by chest pain and swelling of the cartilage around the ribs.
Symptoms
TS is benign, and the life expectancy for people with the condition is normal. Tietze syndrome is a rare inflammatory condition that involves inflammation of the cartilage between the ribs and sternum. The characteristic symptom is chest pain, which may radiate to the neck, shoulders, and arms.
Causes
Sometimes just hearing from your doctor that it’s Tietze syndrome and not a heart attack can reassure you enough to deal with the pain until it goes away on its own. Other treatments can help ease the pain and swelling. These include nonsteroidal anti-inflammatory drugs ( NSAIDs) like ibuprofen, naproxen, and aspirin.
What is Tietze syndrome?
What is the life expectancy of someone with Tietze syndrome?
Can Tietze syndrome be treated without a heart attack?
What causes Tietze syndrome?
The exact cause of Tietze syndrome is unknown. However, researchers believe that it may be the result of small injuries to the ribs.
How does Tietze syndrome feel?
Tietze syndrome pain may: come on suddenly or gradually. feel sharp, stabbing, dull, or aching. range from mild to severe. spread to your arm, neck, and shoulders. get worse if you exercise, cough, or sneeze. Although the swelling may persist, the pain usually decreases after a few weeks.
How does Tietze syndrome differ from costochondritis?
Tietze syndrome and costochondritis both cause chest pain around the ribs, but there are important differences:
What is the best way to diagnose Tietze syndrome?
an electrocardiogram (EKG) to look at how well your heart is working and to rule out heart disease. A diagnosis of Tietze syndrome is based on your symptoms and ruling out other possible causes of your pain.
Who is the doctor who first described Tietze syndrome?
Its exact cause isn’t known. The syndrome is named for Alexander Tietze, the German doctor who first described it in 1909. This article will take a closer look at the symptoms, possible causes, risk factors, diagnosis, and treatment of Tietze syndrome.
How long does it take for Tietze syndrome to heal?
Although the swelling may persist longer, Tietze syndrome pain usually improves within months. Sometimes the condition can resolve and then recur.
What causes Tietze syndrome?
These small are known as microtraumas and are too small to cause damage that is noticeable from the outside, but they may cause damage or swelling to the ribs. These microtraumas could be caused by a sudden event such as a car accident or surgery or due to chronic small traumas such as those that might be caused by frequent coughing or vomiting. [1]
How old do you have to be to have Tietze syndrome?
The signs and symptoms of Tietze syndromeusually develop before age 40. The most common symptom is mild to severe chest pain that may extend into the arms and shoulders. The onset of pain can be sudden or gradual and may worsen with coughing, sneezing, exercise, or quick movements such as opening or closing doors. [1]
How long does it take for Tietze syndrome to subside?
While the pain associated with Tietze syndrome usually subsides after several weeks or months, the swelling may persist. Some people affected by Tietze syndrome have patterns of relapse and remission, meaning they experience periods of pain and periods when the pain subsides. [2]
Does Tietze syndrome resolve on its own?
[1] . In some cases, Tietze syndrome may resolve on its own without treatment, while other people experience patterns of pain followed by some relief of pain. Management for pain includes options such as minimizing physical activity, applying heat or ice as directed by your doctor, ...
Is Tietze syndrome inherited?
Tietze syndromeis not thought to be inherited. Most cases occur sporadicallyin people with no family historyof the condition. [1]
Why is Tietze syndrome so hard to diagnose?
Tietze syndrome can be hard to diagnose because the symptoms are like those of other problems besides a heart attack. They can seem like angina, which is chest pain when your heart muscles don't get enough oxygen. They are also very similar to certain lung problems, rheumatoid arthritis, and costochondritis, also called chest wall pain.
How do you know if you have Tietze syndrome?
Symptoms. The most common symptoms of Tietze syndrome are chest pain and swelling. These can appear suddenly and disappear just as suddenly, or they may develop gradually then come and go for years. It's also possible for the pain to disappear even while the swelling continues.
What tests are done for Tietze syndrome?
They may also order tests to rule out other things. These tests might include X-rays, an ultrasound, magnetic resonance imaging (MRI), a biopsy, or an electrocardiogram to see the electrical activity in your heart.
Does Tietze syndrome go away?
The symptoms of Tietze syndrome usually aren't serious and often will go away with no treatment. Sometimes just hearing from your doctor that it’s Tietze syndrome and not a heart attack can reassure you enough to deal with the pain until it goes away on its own. Other treatments can help ease the pain and swelling.
How to treat Tietze syndrome?
Exercises for Tietze syndrome. In some cases, doctors may recommend physical therapy. A physical therapist may suggest stretches and exercises that the person can do to help manage their TS symptoms. However, some people may need to avoid exercise and physical activity during treatment.
What are the hallmarks of Tietz syndrome?
It is important to note that this condition is different than Tietz syndrome, the hallmarks of which include profound hearing loss, white hair, and very pale skin at birth.
What is TS in the chest?
TS symptoms are the result of inflammation and swelling in the cartilage that connects the upper four ribs to the sternum. Doctors refer to this area as the “costochondral joint.”. The main symptom of TS is a sharp, dull, or aching pain in the chest.
What is the name of the condition that causes pain in the neck and shoulders?
Tietze syndrome is a rare inflammatory condition that involves inflammation of the cartilage between the ribs and sternum. The characteristic symptom is chest pain, which may radiate to the neck, shoulders, and arms.
What causes TS in the chest?
However, some researchers believe that small injuries, or microtraumas, to the chest wall may play a role in the development of the condition. Microtraumas within the chest wall may occur as a result of the following: a sports injury. a car accident.
Why does it take so long to get a diagnosis of TS?
It can take time to receive a diagnosis of TS because doctors will need to rule out more serious causes of chest pain.
How long does TS last?
A 2018 study notes that with standard treatment, the symptoms of TS last an average of 1–2 weeks. . People who experience severe or relapsing-remitting symptoms may require long-term treatment.
How long does Tietze syndrome last?
Most patients report complete resolution of symptoms within 1 to 2 weeks with conservative management, but there have been reports of the characteristic swelling lasting for up to one year. Reoccurrences are also possible.
What causes Tietze syndrome?
Sometimes the development of the disorder may be preceded by chronic, excessive coughing, vomiting, trauma or impact to the chest, viral or bacterial infections, or surgery to the thoracic area. [2][3] Epidemiology. The precise prevalence and incidence of Tietze syndrome are unknown.
Is Tietze syndrome inflammatory?
There have been discussions regarding the possibility that this disease process is inflammatory and may be part of a more comprehensive seronegative pathology.[3] The symptoms are often self-limiting, but Tietze syndrome recurrences are possible.
Is Tietze syndrome a history of trauma?
Patients typically present complaining of acute chest pain with no history of trauma. Due to the younger population in which Tietze syndrome tends to occur, it is not uncommon for the patients to be otherwise healthy. The pain is sharp and stabbing over the swollen area and can radiate to the shoulder and proximal arm. Heat and erythema are not usually associated with the swelling. The patient's discomfort can be made worse with the movement of the ipsilateral arm, movement of the torso, coughing, sneezing, and deep breathing. [2]
Can psoriatic arthritis cause Tietze syndrome?
It may occur more frequently in certain conditions, such as psoria tic arthritis.
Is Tietze syndrome benign?
Cardiac, pulmonary, and neurological exams are typically benign in connection with Tie tze syndrome, and any underlying cardiopulmonary problems discovered upon exam should receive further attention. Evaluation.
Is Tietze syndrome a costochondritis?
Tietze syndrome is most commonly misdiagnosed as costochondritis, as the latter also presents as anterior chest wall pain that is reproduced with palpation at the sternochondral and costochondral junctions. Costochondritis, however, is associated with multiple ribs typically ranging from 2 to 5 and is not associated with localized swelling over the affected joints. Ultrasound will not demonstrate significant findings with costochondritis, whereas sonogram is a mainstay in aiding a Tietze syndrome diagnosis.
How to diagnose Tietze syndrome?
Ruling out other conditions, especially potentially life-threatening ones such as myocardial infarction (heart attack) and angina pectoris, is extremely important as they can present similarly to Tietze syndrome. These can usually be ruled out with diagnostic tools such as an electrocardiogram and a physical examination showing reproduc ible chest wall tenderness, . After eliminating other possible conditions, physical examination is considered the most accurate tool in diagnosing Tietze syndrome. Physical examination consists of gentle pressure to the chest wall with a single finger to identify the location of the discomfort. Swelling and tenderness upon palpation at one or more of the costochondral, sternocostal, or sternoclavicular joints, is a distinctive trait of Tietze syndrome and is considered a positive diagnosis when found.
What causes Tietze syndrome?
Thus, it has been hypothesized that the repetitive mild trauma of a severe cough from a respiratory infection may produce small tears in the ligament called microtrauma, causing Tietze syndrome. However, this theory is disputed as it does not account for symptoms such as the onset of attacks while at rest as well as the fact that swelling sometimes develops before a cough. The respiratory infection has also been observed accompanying rheumatoid arthritis which, coupled with leukocytosis, neutrophilia, c-reactive protein (CRP), and elevated erythrocyte sedimentation rate (ESR), suggest an infectious and rheumatoid factor, though the evidence is conflicting. Many theories such as malnutrition, chest trauma, and tuberculosis, were thought to be among the potential causes but have since been disproven or unsupported.
How is Tietze syndrome differentiated from Costochondritis?
Tietze syndrome is differentiated from costochondritis by swelling of the costal cartilages, which does not appear in costochondritis. Like costochondritis, it was at one time thought to be associated with, or caused by, a viral infection acquired during surgery. This is now known not to be the case, as most sufferers have not had recent surgery.
What imaging is used to diagnose Tietze syndrome?
However, these features can only be identified from a biopsy. Some studies have begun exploring and defining the use of radiographic imaging for diagnosing Tietze syndrome. This includes computed tomography (CT), magnetic resonance imaging (MRI), bone scintigraphy, and ultrasound, though these are only case studies and the methods described have yet to be thoroughly investigated. Methods such as plain radiographs, better known as an x-ray, are helpful in the exclusion of other conditions, but not in the diagnosis of Tietze syndrome. Some researchers believe that ultrasound is superior to other available imaging methods, as it can visualize the increased volume, swelling, and structural changes of the costal cartilage.
How long does it take for Tietze's syndrome to resolve?
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 12 weeks. However, it can often be a chronic condition.
Is Costochondritis the same as Tietze's?
In females, it is often misdiagnosed as mastalgia. Costochondritis symptoms are similar to Tietze's, the prime difference being visible swelling of the rib cartilage and pain that radiates to the arms and shoulders in the latter.
Is Tietze's syndrome inherited?
Tietze's syndrome is not thought to be an inherited condition and it affects males and females equally. Psychological stress can exacerbate Tietze's syndrome through chest muscle contraction, but there is no evidence to suggest that it is a direct cause .
How long does Tietze syndrome last?
Tietze syndrome is eventually self-limiting; however, it follows a pattern of relapse and remission. The pain can spontaneously disappear after a couple of weeks or can last for months , as does the swelling over the affected joints. Treatment consists of reassurance, avoidance of strenuous activity, applying heat or ice as directed by your doctor ...
What are the symptoms of Tietze syndrome?
if you move. Tietze syndrome is characterized by swelling of the cartilage of the ribs, specifically one of the three ribs that are closest to the head. Most cases of Tietze syndrome have symptoms of pain on one side of the body only (unilateral) and affect only one rib.
Where to touch for Tietze syndrome?
If you have symptoms of Tietze syndrome, your doctor will examine and touch the upper chest area around your costochondral joint. They’ll ask you when and where your pain occurs and look at your recent medical history.
When was Tietze syndrome first described?
The exact cause is not known. Tietze syndrome was first described in the medical literature in 1921 by Alexander Tietze, a German surgeon 5).
Is Tietze syndrome related to ethnicity?
There is no causal link between Tietze syndrome and profession, ethnicity, or geography; however, clustered cases have been reported. Although the presenting symptoms of Tietze syndrome can mimic numerous pathological causes of chest pain, it is much better characterized as musculoskeletal chest pain 4). The exact cause is not known.
Is Tietze syndrome rare?
Although rare, Tietze syndrome has been reported in infants, children or the elderly. The exact incidence or prevalence of Tietze syndrome is unknown. The cause of Tietze syndrome is not known, but a traumatic pathogenesis cannot be excluded. There is no causal link between Tietze syndrome and profession, ethnicity, or geography; however, ...
Is Costochondritis a young adult?
Costochondritis also tends to affect adults aged 40 or over, whereas Tietze’s syndrome usually affects young adults under 40. Tietze syndrome usually presents in young adults (younger than 40 years), both male and female. Although rare, Tietze syndrome has been reported in infants, children or the elderly. The exact incidence or prevalence of ...
What is Tietze Syndrome?
Tietze syndrome is known to be a benign inflammation of one or more of the costal cartilages. (1) It affects mostly people below 40 years of age. This syndrome was described first in the year 1921 by a German surgeon Alexander Tietze.
What age group is most affected by Tietze syndrome?
Tietze syndrome mostly affects children and those below the age of 40 years. A study conducted in the year 2017 noted that the number of cases of Tietze syndrome was higher in winter to the spring period. (3) The same study also found a higher proportion of women develop this syndrome.
What is the pain in the chest from Tietze syndrome?
Chest Pain: The primary symptom of Tietze syndrome is chest pain. In this condition, the affected person feels pain around one or more of the upper four ribs , especially where the ribs are attached to your breastbone. In around 70% to 80% of cases, the pain is located around only a single rib and usually, only a single rib of the chest is involved. (2) Inflammation of the cartilage of the affected rib leads to chest pain. This area of the cartilage is known to be the costochondral junction. The pain in the chest can appear all of a sudden and also disappear suddenly, or they might develop in a gradual way then come and go for several years. Sneezing, coughing, exercising, or any other physical activity, laughing, deep breathing, hugging someone, wearing the seatbelt, or even simply lying down might worsen the pain. The pain in Tietze syndrome sometimes might extend to the neck, arms, and shoulders. This pain can be mild or severe, dull or sharp. For some people, this pain feels as if being stabbed with a knife. One might mistake the chest pain from Tietze syndrome for a heart attack; however, there are some differences. In the case of Tietze syndrome, the pain affects only a small area of your chest while a heart attack covers the entire chest. You might also be short of breath, suffering from nausea, and sweating when you have a heart attack, which is not experienced in the case of Tietze syndrome.
How long does it take for Tietze syndrome to go away?
Though swelling might persist for a long time, pain in Tietze syndrome will generally improve within months. At times, the condition might get resolved and then recur.
What is the best medicine for Tietze syndrome?
NSAIDs: Your doctor might prescribe you with some pain relievers like the OTC Nonsteroidal anti-inflammatory drugs or the NSAIDs for helping you out with the pain that occurs due to Tietze syndrome. In case your pain persists then you might be prescribed with a stronger pain reliever.
Is Tietze syndrome the same as Costochondritis?
We must mention here that Tietze syndrome is not something similar to costochondritis, and it differs from the condition of costochondritis by swelling that occurs in the costal cartilages, which generally does not appear in costochondritis.
Does Tietze syndrome affect men?
However, there are several other studies that have found that Tietze syndrome affects both, men and women equally.
What are the symptoms of Tietze Syndrome?
This might increase in intensity upon deep inhaling, sighing, sneezing or coughing. Sometimes the pain might radiate towards back, neck, shoulder and arm . Besides, a cramped and compelling feeling might arise. The impression can then arise that there are heart problems. This can trigger such an appalling feeling that hyperventilation can sometimes occur. Because of the inflammations, the skin can get a reddish color. In some patients the function of the esophagus, stomach, intestines and lungs may be disturbed.
How to treat Tietze's syndrome?
There is no treatment for Tietze’s syndrome yet . The doctor will therefore focus on relieving the pain. In most cases, he will prescribe an anti-inflammatory analgesic (NSAID). In case of annoying side effects, the liquid Green-lipped mussel with Bio-Curcumin and Blackcurrant leaf can be tried as an alternative. This natural anti-inflammatory compound is active in the area around the joints. Also, the physician can give a corticosteroid injection to the painful place or decide to block the nerve between the ribs. One can also be referred to posture- or exercise therapist, such as physiotherapy, Cesar or Mensendieck. The complaints often disappear over time. However, in some patients Tietze’s syndrome progress into a chronic form.
How is Tietze’s syndromediagnosed?
Tietze’s syndrome cannot be demonstrated by X-rays or a blood test. The swelling of the cartilage in the chest is not visible on X-rays. Also, the disease does not leave traces in the blood. Your doctor will therefore have to rely on your story regarding with what physical complaints you have to deal exactly. Usually, you will be referred to the hospital for a number of examinations. These aim to exclude other conditions – such as angina pectoris, gastric ulcer, pancreatitis, pulmonary embolism and heart disease.
Why does Tietze's syndrome occur?
It may originate from overload to the chest caused by lifting heavy objects, sustained coughing and work in a bent over position. However, Tietze’s syndrome may also arise from an accident with large effective force on the chest, respiratory infection, pregnancy and rheumatoid arthritis.
How to keep moving in Tietze syndrome?
In addition to keep moving enough, you can do these exercises daily. Exercise 1: breathing. Take place on a chair.
Is Tietze's syndrome serious?
Tietze’s syndrome is not a serious condition but is accompanied by a nasty pain. The symptoms might resemble that of a heart infarct. Tietze’s syndrome may develop very slowly but can also become suddenly manifest. It’s equally present in men and women.
