Tietze Syndrome

• • Painful, nonsuppurative inflammation of costochondral cartilage

  • Unknown cause

  • May represent seronegative rheumatic disease

  • Often self-limited

  • Unilateral or bilateral

  • Involves second-fourth costal cartilages

Symptoms and Signs

• • Local swelling, tenderness in parasternal area

Imaging Findings

• • Bone scan: Can localize inflamed costochondral junctions

  • Chest CT: Can localize, but less sensitive than bone scan

  • Transthoracic echocardiography: May demonstrate pathologic cartilage hyperechogenicity

Rule Out

• • Costochondral neoplasm: if symptoms last longer than 3 wks

  • Breast pain/causes

• • Physical exam

  • Consider chest CT or bone scan; usually not needed

• • If symptomatic, NSAIDs, local or systemic corticosteroids

Surgery

Indications

• • If symptoms longer than 3 wks and mass is present, consider neoplasm and excise

References