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Costochondritis(idiopathic)

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Tietze's syndrome is an idiopathic costochondritis.

The patient complains of pain that is often localized to the costal cartilage.

  • the syndrome usually affects the second rib, followed by the third and fourth
  • the pain is made worse by motion, coughing, or sneezing
  • there is localized tenderness

Investigations:

  • chest xray and bone scan are not helpful for diagnosis
  • computed tomography findings are considered to be specific for osteochondritis of the rib

Treatment is with analgesia. In persistent cases local steroid injections may be indicated.

Notes:

  • Tietze's syndrome usually occurs in the second through fourth decades of life and rarely has been described in children
    • in the paediatric age group, the presence of a costochondral mass is often alarming and the possibility of a tumour (benign or malignant) or septic joint must be considered (2)

Reference:

  1. Yurik AG, Graudal H. Sternocostal joint swelling - clinical Tietze’s syndrome. Scand J Rheumatol 1988;17: 33–42.
  2. Mukamel M et al. Tietze's syndrome in children and infants. J Pediatr. 1997 Nov;131(5):774-5
  3. Honda N et al. Scintigraphic and CT findings of Tietze syndrome; report of a case and review of the literature. Clin Nucl Med 1989;8: 606–608.

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