What are the main causes of costochondritis. How is costochondritis diagnosed. What are the most effective treatments for costochondritis. When should you seek medical attention for chest pain. How can you differentiate costochondritis from a heart attack.

Understanding Costochondritis: A Comprehensive Overview

Costochondritis is an inflammatory condition affecting the cartilage that connects the ribs to the breastbone (sternum). This condition can cause significant discomfort and pain in the chest wall, particularly around the second to fifth ribs. While the exact prevalence is unclear, studies suggest that costochondritis accounts for 13-36% of chest pain cases in emergency departments.

The pain associated with costochondritis can be alarming, as it often mimics the sensation of a heart attack. This similarity in symptoms can cause considerable anxiety for those experiencing it. However, understanding the nature of costochondritis and its distinguishing features can help alleviate some of this concern.

Key Characteristics of Costochondritis

• Pain typically localized to the chest wall
• Discomfort may be described as stabbing, burning, or aching
• Pain often worsens with movement, deep breathing, or coughing
• Usually affects the left side of the chest, but can be bilateral
• Most commonly affects individuals over 40 years old

Unraveling the Causes of Costochondritis

The exact cause of costochondritis often remains elusive, with many cases classified as idiopathic (of unknown origin). However, several factors have been identified as potential triggers or contributors to the development of this condition:

1. Persistent coughing due to respiratory illnesses
2. Strenuous exercise or heavy lifting involving the upper body
3. Trauma or injury to the chest wall
4. Recent chest infections or surgeries
5. Carrying heavy, unbalanced loads (e.g., backpacks)
6. Physical strain associated with large breasts

Is there a genetic predisposition to costochondritis? While current research doesn’t strongly support a genetic link, some studies suggest that certain individuals may be more susceptible to developing inflammatory conditions affecting cartilage and connective tissues. Further investigation is needed to fully understand potential genetic factors.

Recognizing the Symptoms: When to Suspect Costochondritis

Identifying the symptoms of costochondritis is crucial for proper diagnosis and treatment. The primary symptom is chest pain, which can vary in intensity and character. Here are some key features to look out for:

• Sharp or dull ache in the chest, often on the left side
• Pain that worsens with movement, deep breathing, or coughing
• Tenderness when pressing on the affected area
• Discomfort that may radiate to the back or abdomen
• Symptoms that tend to worsen with physical activity

How can you differentiate costochondritis pain from other chest pain? Unlike heart-related chest pain, costochondritis discomfort typically:
– Increases with chest wall movement or pressure
– Remains localized to a specific area
– Does not usually cause shortness of breath or other systemic symptoms

Tietze Syndrome: A Close Relative of Costochondritis

Tietze syndrome is a condition closely related to costochondritis, sharing many similarities but with some distinct features. Understanding the differences between these two conditions can help in accurate diagnosis and appropriate management.

Key Distinctions of Tietze Syndrome

• Visible swelling of the affected costal cartilage
• Typically affects the upper ribs (2nd or 3rd)
• More common in younger individuals
• Swelling may persist even after pain subsides
• Considered a rare disorder

Why is Tietze syndrome considered rare compared to costochondritis? The exact prevalence of Tietze syndrome is not well-established, but it is generally observed less frequently than costochondritis in clinical practice. This rarity may be due to stricter diagnostic criteria, including the presence of visible swelling, which is not a feature of typical costochondritis.

Diagnostic Approaches for Costochondritis

Diagnosing costochondritis can be challenging due to its similarity to other conditions causing chest pain. Doctors typically employ a combination of methods to reach an accurate diagnosis:

1. Thorough medical history
2. Physical examination, including palpation of the chest wall
3. Exclusion of other serious conditions (e.g., heart attack, pneumonia)
4. Imaging studies (in some cases) to rule out other causes

Are there specific tests to confirm costochondritis? While there is no definitive test for costochondritis, the diagnosis is primarily based on clinical findings. In some cases, doctors may order additional tests such as:
– Electrocardiogram (ECG) to rule out heart-related issues
– Chest X-ray to exclude lung problems
– Blood tests to check for signs of inflammation or infection

Effective Treatment Strategies for Costochondritis

The management of costochondritis typically focuses on symptom relief and addressing any underlying causes. Treatment approaches may include:

Conservative Measures

• Rest and activity modification
• Application of heat or cold therapy
• Over-the-counter pain relievers (e.g., ibuprofen, acetaminophen)
• Gentle stretching and posture correction

Medical Interventions

• Prescription-strength anti-inflammatory medications
• Local anesthetic or corticosteroid injections (in severe cases)
• Physical therapy to improve chest wall flexibility and strength

How long does it typically take for costochondritis to resolve? The duration of symptoms can vary widely among individuals. Many cases improve within a few weeks with conservative treatment, while some may persist for several months. Chronic cases lasting more than a year are less common but can occur.

Prevention Strategies and Long-Term Management

While not all cases of costochondritis can be prevented, certain measures may help reduce the risk of developing or exacerbating the condition:

1. Practice good posture and ergonomics
2. Avoid overexertion and use proper lifting techniques
3. Manage underlying respiratory conditions to minimize coughing
4. Maintain a healthy weight to reduce strain on the chest wall
5. Engage in regular, low-impact exercise to improve overall musculoskeletal health

Can dietary changes help manage costochondritis? While there’s no specific diet proven to directly impact costochondritis, adopting an anti-inflammatory diet rich in omega-3 fatty acids, fruits, vegetables, and whole grains may support overall musculoskeletal health and potentially reduce inflammation.

When to Seek Medical Attention: Recognizing Red Flags

Although costochondritis is generally not life-threatening, it’s crucial to know when to seek immediate medical care. The following symptoms warrant urgent attention:

• Severe, persistent chest pain unrelieved by rest or medication
• Shortness of breath or difficulty breathing
• Fever above 100.4°F (38°C) in adults
• Chest pain radiating to the arms, jaw, or back
• Irregular heartbeat or palpitations
• Dizziness, lightheadedness, or fainting

How can you differentiate between costochondritis and a heart attack? While it can be challenging for individuals to distinguish between these conditions, some key differences include:
– Costochondritis pain typically worsens with movement or pressure on the chest wall
– Heart attack pain often feels like a crushing or squeezing sensation and may be accompanied by other symptoms like nausea or sweating
– Costochondritis doesn’t usually cause shortness of breath or radiating pain to the arms or jaw

Living with Costochondritis: Coping Strategies and Quality of Life

For individuals dealing with costochondritis, especially in chronic cases, developing effective coping strategies is essential for maintaining quality of life. Here are some approaches that may help:

Lifestyle Adaptations

• Modify activities to avoid exacerbating symptoms
• Use supportive devices (e.g., ergonomic chairs, back supports)
• Practice stress-reduction techniques like meditation or yoga
• Maintain a regular sleep schedule to promote healing

Pain Management Techniques

• Explore alternative therapies like acupuncture or massage (with medical approval)
• Learn breathing exercises to minimize chest wall strain
• Consider cognitive-behavioral therapy to address pain-related anxiety

How can you maintain an active lifestyle with costochondritis? While it’s important to avoid activities that worsen symptoms, staying active is beneficial for overall health. Low-impact exercises like walking, swimming, or gentle yoga can help maintain fitness without putting excessive strain on the chest wall. Always consult with a healthcare provider before starting any new exercise regimen.

Recent Advances in Costochondritis Research and Treatment

The field of musculoskeletal medicine continues to evolve, bringing new insights into conditions like costochondritis. Recent developments include:

1. Improved diagnostic imaging techniques for better visualization of costal cartilage
2. Investigation of novel anti-inflammatory agents with fewer side effects
3. Exploration of regenerative medicine approaches for cartilage health
4. Studies on the potential role of biomechanical factors in costochondritis development

Are there any promising new treatments on the horizon for costochondritis? While research is ongoing, some areas of interest include:
– Targeted biologic therapies to modulate inflammation
– Advanced physical therapy techniques incorporating ultrasound guidance
– Exploration of neuroplasticity-based approaches for chronic pain management

Understanding the Psychological Impact of Costochondritis

The experience of chronic chest pain can have significant psychological effects on individuals with costochondritis. Recognizing and addressing these aspects is crucial for comprehensive care:

Common Psychological Challenges

• Anxiety related to fear of serious cardiac conditions
• Depression associated with chronic pain and activity limitations
• Frustration due to the often prolonged and unpredictable nature of symptoms
• Social isolation resulting from reduced participation in activities

Coping Strategies

• Seeking support from mental health professionals
• Joining support groups for individuals with chronic pain
• Practicing mindfulness and relaxation techniques
• Educating family and friends about the condition to foster understanding

How can healthcare providers better address the psychological aspects of costochondritis? A multidisciplinary approach involving pain specialists, mental health professionals, and primary care providers can ensure comprehensive care. Incorporating psychological assessments and interventions into treatment plans can significantly improve outcomes and quality of life for individuals with costochondritis.

Costochondritis in Special Populations

While costochondritis can affect individuals of all ages and backgrounds, certain populations may require special considerations in diagnosis and management:

Pediatric Costochondritis

• More common in adolescents, especially those involved in sports
• May be associated with growth spurts and changing chest wall dynamics
• Differential diagnosis should include conditions like Slipping Rib Syndrome

Costochondritis in Pregnancy

• Can be exacerbated by postural changes and weight gain during pregnancy
• Treatment options may be limited due to medication restrictions
• Importance of proper support and ergonomics during pregnancy and postpartum

Elderly Patients

• May have comorbid conditions complicating diagnosis and treatment
• Increased risk of medication side effects and interactions
• Importance of maintaining mobility and independence while managing symptoms

How does the approach to costochondritis differ in these special populations? Healthcare providers must tailor their diagnostic and treatment strategies to account for age-specific factors, comorbidities, and life circumstances. For example:
– In pediatric cases, growth-related factors and sports participation should be considered
– During pregnancy, non-pharmacological approaches may be emphasized
– In elderly patients, a comprehensive geriatric assessment may guide treatment decisions

The Role of Complementary and Alternative Medicine in Costochondritis Management

As interest in holistic health approaches grows, many individuals with costochondritis explore complementary and alternative medicine (CAM) options. While scientific evidence for these methods in treating costochondritis specifically is often limited, some patients report benefits:

Popular CAM Approaches for Costochondritis

• Acupuncture for pain relief and improved chest wall mobility
• Herbal remedies with anti-inflammatory properties (e.g., turmeric, ginger)
• Chiropractic care focusing on spinal and rib alignment
• Massage therapy to relieve muscle tension in the chest and upper back
• Mind-body practices like tai chi or qigong for stress reduction and gentle movement

Are these complementary approaches safe and effective for costochondritis? The safety and efficacy of CAM therapies can vary widely. While some individuals find relief through these methods, it’s crucial to:
– Consult with a healthcare provider before starting any new treatment
– Choose qualified practitioners for hands-on therapies
– Be aware of potential interactions between herbal remedies and conventional medications
– Maintain realistic expectations and continue with evidence-based treatments as recommended by your doctor

Future Directions in Costochondritis Research and Care

As our understanding of musculoskeletal disorders evolves, several areas of research hold promise for improving the diagnosis and treatment of costochondritis:

1. Advanced imaging techniques for more precise diagnosis
2. Genetic studies to identify potential risk factors
3. Development of targeted therapies for cartilage inflammation
4. Investigation of the microbiome’s role in inflammatory conditions
5. Integration of wearable technology for real-time symptom monitoring

What potential breakthroughs might we see in costochondritis care in the coming years? While it’s difficult to predict specific advancements, some areas of interest include:
– Personalized medicine approaches based on genetic and biomarker profiles
– Novel drug delivery systems for localized anti-inflammatory treatment
– Virtual reality applications for pain management and rehabilitation
– Artificial intelligence-assisted diagnostic tools for more accurate differentiation from other chest pain causes

As research progresses, individuals with costochondritis can look forward to more targeted and effective treatment options, potentially improving outcomes and quality of life for those affected by this challenging condition.

Costochondritis: Causes, symptoms, and treatment

Costochondritis is an inflammation of the cartilage connecting the ribs to the breastbone. It can cause a stabbing, burning, or aching pain in the chest wall, especially around the second to fifth ribs. Coughing and a blow to the chest are among the causes.

The ribs are connected to the breastbone by tough, protective tissue called cartilage. When this cartilage becomes inflamed, the condition is known as costochondritis or chest wall pain.

While this condition is usually temporary, it can be alarming, as the pain can become so significant it mimics a heart attack.

Doctors may also refer to costochondritis as costosternal syndrome or costosternal chondrodynia. The condition will usually resolve on its own with home treatments.

Fast facts on costochondritis

• In many cases, doctors do not know what causes costochondritis.
• Pain in the chest and breastbone area is the chief symptom of costochondritis.
• The pain may be so severe that the person feels they are having a heart attack.
• Treatment includes anti-inflammatory medications.

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Share on PinterestUsually costochondritis will resolve itself with home treatment, and is a temporary condition.

Though causes are often unknown, in some instances, the condition can be the result of one or more of the following:

• history of an illness that causes a lot of coughing
• heavy lifting or strenuous exercise, involving the upper extremities and chest wall
• carrying heavy bags, such as a heavy backpack on one side or the other
• having large breasts
• history of chest injuries or chest infections
• undergoing surgery that affects the chest wall, such as cardiac bypass

Doctors call costochondritis that has no known causes idiopathic costochondritis.

Chest discomfort and pain may be stabbing, burning, or aching in nature. The ribs most affected are the second to fifth ones.

The condition most commonly affects those older than age 40, according to an article in the journal American Family Physician. An estimated 13-36 percent of those who seek emergency medical attention for chest pain are experiencing costochondritis.

The following activities usually worsened the pain associated with costochondritis:

• significant amount of coughing
• strenuous exercise
• physical activity using the upper arms, such as lifting boxes

The pain associated with costochondritis usually occurs on the left side of the body but can affect both sides.

Tietze syndrome

There is a variation of costochondritis called Tietze syndrome. This condition causes pain associated with costochondritis, as well as swelling of the rib cartilage.

The swelling of Tietze syndrome affects at least one of the upper four ribs, usually the second or third ribs. While the pain associated with costochondritis may subside with time, some people with Tietze syndrome will still experience the swelling.

Although doctors have not defined how prevalent this condition is, they do consider it to be a rare disorder. Other than pain and discomfort, it does not cause any long-term harmful effects.

Share on PinterestThe symptoms of costochondritis can be worsened by certain activities, such as lifting heavy objects, or strenuous coughing.

Doctors usually treat costochondritis conservatively. Resting and avoiding strenuous exercise that affects the chest wall can help. So can over-the-counter pain relievers, such as ibuprofen or acetaminophen.

Children under age 18 should not take aspirin due to the increased risk for Reye’s syndrome.

In rare instances, a doctor may recommend injections of lidocaine or corticosteroids to reduce pain and inflammation. Other treatments that may help to relieve chest pain include:

• Applying moist heat by way of warm compresses.
• Taking cough suppressants to ease coughing and reduce pressure to the cartilage.
• Physical therapy to ease tension in the chest wall.

If these treatments do not reduce a person’s incidence of costochondritis, they should seek a follow-up with their doctor.

If a person is having chest pain, they should not try to determine for themselves if it is a heart-related issue or costochondritis. Instead, they should seek immediate medical attention.

If a younger person who is not at risk of heart attack experiences these symptoms, they should seek emergency attention if their chest pain is sharp and does not improve with rest.

If someone has gone to a doctor for their symptoms and has been diagnosed with costochondritis, there are still some instances when a person should seek immediate medical attention again. These include:

• feeling faint, dizzy, or lightheaded
• feeling as if the heart is beating irregularly or too fast
• pain that worsens over time or cannot be relieved by pain medicine
• having a shortness of breath
• a fever that is higher than 100.4 °F in an adult
• coughing up dark-colored sputum or blood

If the chest pain is radiating to the arms, neck, shoulder, jaw, or back, a person should seek immediate medical attention.

Share on PinterestSome conditions may seem similar to costochondritis, including an injured shoulder or neck, or arthritis of the surrounding joints.

Doctors often diagnose costochondritis by ruling out other potential causes of the chest pain and discomfort connected with the condition. For example, if a person is older than 35, a doctor may first want to rule out coronary artery disease (CAD), as a potential cause.

Individuals who are at risk of CAD, such as those with a family history, those who are obese, or those with a history of smoking, should usually have an electrocardiogram (ECG or EKG) and chest X-ray to check for CAD.

Other medical conditions that may closely resemble costochondritis include:

• arthritis of the shoulder or nearby joints
• chest wall infections or cancer
• fibromyalgia, a condition that causes nerve pain
• slipping rib syndrome, when there is too much mobility in the cartilage supporting the ribs
• injuries to the shoulder or neck that causes pain to refer or travel to the chest wall

A physical examination to detect tenderness of the cartilage to the touch may also be performed. If a person is having a heart attack or has another type of heart condition, the cartilage in the chest is not usually sensitive to the touch.

A doctor will also listen to the heart and lungs, as well as examine the skin for any signs of infection. An X-ray or other imaging studies will not show signs of costochondritis.

Doctors can usually diagnose a child, adolescent, or young adult by asking questions about their medical history and by conducting a physical exam. The doctor will often check for tenderness in the chest cartilage, as part of this.

According to American Family Physician, costochondritis can last anywhere from a few weeks to months. It may also recur if it has been caused by physical exercise or strain.

The condition does not usually last longer than one year. However, adolescents with costochondritis can sometimes have a longer period of symptoms.

Costochondritis | Beacon Health System

Overview

Costochondritis (kos-toe-kon-DRY-tis) is an inflammation of the cartilage that connects a rib to the breastbone (sternum). Pain caused by costochondritis might mimic that of a heart attack or other heart conditions.

Costochondritis is sometimes known as chest wall pain syndrome, costosternal syndrome or costosternal chondrodynia. Sometimes, swelling accompanies the pain (Tietze syndrome).

What causes costochondritis is unclear. Treatment focuses on easing the pain while waiting for the condition to improve on its own, which can take several weeks or more.

Symptoms

The pain associated with costochondritis usually:

• Occurs on the left side of your breastbone
• Is sharp, aching or pressure-like
• Affects more than one rib
• Can radiate to arms and shoulders
• Worsens when taking a deep breath, coughing, sneezing or with any chest wall movement

When to see a doctor

For chest pain, seek emergency medical attention to rule out life-threatening causes such as a heart attack.

Causes

Costochondritis usually has no clear cause. However, costochondritis might be associated with trauma, illness or physical strain, such as severe coughing.

Risk factors

Costochondritis occurs most often in women older than 40.

Tietze syndrome usually occurs in teenagers and young adults, and with equal frequency in men and women.

Diagnosis

During the physical exam, a health care provider will feel along your breastbone for tenderness or swelling. The provider might also move your rib cage or your arms in certain ways to try to trigger symptoms.

The pain of costochondritis can be similar to the pain associated with heart disease, lung disease, gastrointestinal problems and osteoarthritis. There is no laboratory or imaging test to confirm a diagnosis of costochondritis. But a health care provider might order certain tests, such as an electrocardiogram and chest X-ray, to rule out other conditions.

Treatment

Costochondritis usually goes away on its own, although it might last for several weeks or longer. Treatment focuses on pain relief.

Medications

Your health care provider might recommend:

• Nonsteroidal anti-inflammatory drugs. You can buy some types of these drugs, such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve, others), over the counter. Stronger versions are available by prescription. Side effects can include damage to the stomach lining and kidneys.
• Narcotics. If pain is severe, a provider might prescribe a narcotic medication such as tramadol (Ultram). Narcotics can be habit-forming.
• Antidepressants. Tricyclic antidepressants, such as amitriptyline, are often used to control chronic pain — especially if the pain interferes with sleep.
• Anti-seizure drugs. The epilepsy medication gabapentin (Gralise, Neurontin) has also proved successful in controlling chronic pain.

Therapies

Physical therapy treatments might include:

• Stretching exercises. Gentle stretching exercises for the chest muscles might be helpful.
• Nerve stimulation. In a procedure called transcutaneous electrical nerve stimulation (TENS), a device sends a weak electrical current via adhesive patches on the skin near the area of pain. The current might interrupt or mask pain signals, preventing them from reaching the brain.

Surgery or other procedures

If conservative measures don’t work, another option is to inject numbing medication and a corticosteroid directly into the painful joint.

Lifestyle and home remedies

It can be frustrating to know that there’s little to do to treat costochondritis. But self-care measures, such as the following, might help.

• Nonprescription pain relievers. Acetaminophen (Tylenol, others) ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve, others) may be helpful.
• Topical pain relievers. These include creams, gels, patches and sprays. They may contain nonsteroidal anti-inflammatory drugs or numbing medications. Some varieties contain capsaicin, the substance that makes hot peppers spicy.
• Heat or ice. Try placing hot compresses or a heating pad on the painful area several times a day. Keep the heat on a low setting. Ice also might be helpful.
• Rest. Avoid or modify activities that might worsen pain.

Preparing for an appointment

You may be referred to a doctor who specializes in disorders of the joints (rheumatologist).

What you can do

Ask a relative or friend to accompany you, to help you remember what the provider says.

Make a list of:

• Symptoms, including any that may seem unrelated to the reason for the appointment, and when they began
• Key medical information, including other conditions you have and any injury to the painful joint
• Key personal information, including major life changes or stressors
• All medications, vitamins and supplements, including doses
• Questions to ask the health care provider

Questions to ask your doctor

• What’s the most likely cause of my symptoms?
• What tests do I need?
• What self-care steps are likely to help?
• Do I need to restrict activities?
• What new signs or symptoms should I watch for?
• When can I expect my symptoms to resolve?
• I have other health conditions. How can I best manage them together?

Don’t hesitate to ask other questions.

What to expect from your doctor

Your health care provider is likely to ask you a number of questions, including:

• Have your symptoms worsened over time?
• Where is your pain?
• Does exercise or physical exertion make your symptoms worse?
• Does anything else make your pain worse or better?
• Are you having difficulty breathing?
• Have you had recent respiratory infections or injuries to your chest?
• Are you aware of a history of heart problems in your family?

Last Updated: May 11th, 2022

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Tietze’s syndrome: symptoms and treatment, causes of the disease costal chondritis

Articles

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cartilage. Most often, the pathology occurs in people aged 20-40 years, with the same frequency in men and women. The causes and clinical manifestations are diverse, so in patients with Tietze syndrome, symptoms and treatment can be drastically different. The main manifestation of the disease is chest pain, which also occurs in many pathologies of the internal organs and the musculoskeletal system. Due to the blurring of the clinical picture, it is difficult to make a differential diagnosis.

This article is a recommendation. Treatment is prescribed by a specialist after consultation.

Causes

The first ten pairs of ribs are connected to the sternum through cartilage, forming the costosternal joints, which can be damaged due to overload of the shoulder girdle. Microtraumatization of the perichondrium, the shell of the cartilage, leads to the development of non-infectious inflammation in it. Over time, the cartilage deforms, grows, compresses the surrounding nerve endings, causing pain. According to histological studies, after two to three months from the onset of the development of Tietze’s syndrome, the cartilage tissue is actually transformed into bone.

Fig. 1 Costosternal joints

Tietze’s syndrome is a rare pathology. The reasons for its development can be any diseases that disrupt the metabolism in the connective tissue and reduce immunity, as well as mechanical damage.

Risk factors for the development of Tietze’s syndrome:

• The same monotonous physical activity on the arms and chest

• Chest injuries

• O chest surgery

• Metabolic defects in the connective tissue

• Costal chondritis – inflammation of the costal cartilages

• COPD), bronchial asthma, etc.

Symptoms

The clinical picture of the disease is similar to pneumonia, exacerbation of COPD, bronchial asthma, coronary heart disease, myocardial infarction, intercostal neuralgia and osteochondrosis.

Possible symptoms of cartilaginous rib joint syndrome:

• 1

  Sharp shooting pain in the anterior chest wall. It can hurt on one side, rarely on both. Sometimes it radiates to the neck, back or arms

• 2

  Over time, the pain becomes undulating, aggravated by movement, deep breathing and pressure on the attachment points of the ribs to the sternum

• 3

  900 02 Possible spasm of the sternocleidomastoid muscles located on the anterior-lateral surfaces of the neck, right or left pectoralis major muscle – depending on which side of the chest the ribs are affected

• 4

  Limited range of motion in the neck, right or left shoulder joint, limitation of the depth of inhalation and exhalation

• ber with sternum. Education gradually hardens, becoming “bone”. When pressing on it, the pain intensifies, “shoots through”

• 6

  Increase in body temperature up to 38-39 degrees, general weakness, sweating

• 7

  Possible shortness of breath, loss of appetite, insomnia and tachycardia

Symptoms may develop acutely or gradually. Most often, Tietze’s disease of the chest affects the II-IV ribs.

Diagnosis

The symptoms of Tietze’s syndrome are similar to those of other diseases of systems and organs. In addition, some patients do not have local signs of inflammation, further complicating the diagnosis. An important role is assigned to a thorough clarification of complaints, anamnesis, visual examination and palpation. To clarify the diagnosis, an instrumental examination is often prescribed.

Additional diagnostic options:

• Chest x-ray to rule out lung disease and cancer
• Chest spiral computed tomography (SCT) for better visualization of pathological changes
• MRI chest for soft tissue assessment
• ECG
• Echocardiography, or ultrasound of the heart to rule out cardiac pathology

Which doctor to contact

In case of chest pain, they often turn to cardiologists and neurologists, and in case of induration in the anterior chest wall, to an oncologist. However, Tietze’s syndrome is dealt with by surgeons and orthopedic traumatologists.

The doctor conducts a survey and examination of the patient, prescribes additional examinations to clarify the diagnosis. How to treat costal chondritis, the specialist decides, taking into account the cause and severity of the condition.

Make an appointment with a neurologist

Appointment lasts 60 minutes, includes diagnostics, analysis of your MRI and preparation of a treatment plan, takes place both in person and online.

Treatment

At the Temed Clinic, patients with Tietze’s syndrome are treated in a complex manner by several narrow specialists: a neurologist, an orthopedic traumatologist, a masseur, a physiotherapist. Treatment of the disease is conservative. Surgical intervention – removal of the affected part of the rib – is resorted to extremely rarely, with an advanced stage of the disease. The emphasis in the treatment of costal chondritis is on taking medications, physiotherapy.

Medical treatment includes non-steroidal anti-inflammatory drugs (NSAIDs) and, in some cases, glucocorticosteroids to relieve inflammation, localized swelling, and pain.

Tietze’s syndrome often occurs in a chronic form, requiring constant pain relief. But due to long-term use of medications, there are side effects. Therefore, drugs are prescribed only during the period of exacerbation in order to relieve inflammation. The basis of treatment is physiotherapy.

Temed Clinic focuses on modern and effective techniques:

• Acupuncture . The doctor introduces special thin needles into biologically active points, stimulating the nerve fibers leading to the pathological focus. Pain intensity decreases and tissue recovery accelerates

• Pharmacopuncture . Subcutaneous injections of drugs into the pathological focus relieve inflammation, swelling, stimulate tissue healing and eliminate pain. The procedure quickly relieves the patient’s condition. The choice of drugs and their combination depends on the severity of symptoms

• Taping . By fixing the elastic bands along the course of the muscles in a certain direction, the doctor redistributes the load on the joints of the shoulder girdle and chest. Kinesio taping for post-traumatic costal chondritis accelerates recovery, makes you feel better and allows you to reduce the dosage of drugs taken

• Magnetotherapy . The modern BTL Super Inductive System technology relieves chest pain, increases the mobility of the costosternal joints and triggers regeneration processes

• Laser therapy . MLS 6, a robotic multi-wavelength system, emits various tunable waves. With its help, the doctor achieves analgesic, anti-inflammatory and anti-edematous effects. The laser acts pointwise, the procedure is as safe as possible

• exercise therapy . Therapeutic exercise for Tietze’s syndrome includes individually selected exercises aimed at improving the mobility of the chest, developing the rib-sternal joints. Exercise therapy is often combined with taping: tapes increase the effectiveness of gymnastics

• Massage . The specialist kneads the muscles of the chest, which improves the nutrition of soft tissues. The procedure is carried out only after the exacerbation is removed

The treatment lasts from two to three weeks to several months until the symptoms are completely resolved. To improve and consolidate the result of therapy, patients perform exercises for Tietze’s syndrome at home for at least 2 weeks. Costosternal joints can crackle, during their development recovery occurs, nutrition and mobility of the chest as a whole improves.

In case of slow dynamics or its absence during therapy, it is recommended to consult an oncologist and repeat an in-depth examination of the patient with a mandatory puncture biopsy of the chest mass.

Prophylaxis

No specific prophylaxis. Overloading of the shoulder girdle, chest injuries and diseases of the respiratory system should be avoided. To prevent exacerbations, it is enough to follow the simple recommendations of a traumatologist, regularly perform gymnastics, eat a balanced diet and lead an active lifestyle.

Consequences

With timely diagnosis and treatment, the prognosis is favorable. Without therapy, the disease becomes chronic: exacerbations alternate with remissions. The pain may disappear spontaneously after 2-4 weeks, and reappear after a couple of months.

Theses

• 1

  Tietze’s syndrome is a rare disease characterized by non-infectious inflammation of one or more upper costal cartilages where the ribs meet the sternum

• 2

  The main symptom of Tietze’s syndrome is chest pain and an elastic mass on the anterior chest wall

• 3

• 4

  Treatment of Tietze’s syndrome is based on drugs, physiotherapy and therapeutic exercises

List of sources:

1. Shesternya P. A., Vasilyeva A.O., Shkil L.M., Onishchenko S.B., Mikhailova K.O., Nikitina M.A., Siberian Medical Review magazine, article “Tietze syndrome – an interdisciplinary clinical case”, 2017, Krasnoyarsk.
2. Vodoevich V.P., Breido A.A., Varnakova G.M., Lemeshevskaya P., Masilevich A.M. Grodno, Belarus.
3. Zhukovskaya A.O., Moskalenko I.S., journal “Symbol of Science”, article “Titze’s disease (costal chondritis)”, 2017,

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How to Diagnose Tietze’s Syndrome (Costocartilaginous Syndrome, Costal Chondritis) : Costochondral syndrome is a disease from the group of chondropathy, accompanied by aseptic inflammation of one or more upper costal cartilages in the area of ​​their articulation with the sternum. The initial diagnosis of Tietze’s syndrome will require an X-ray or CT scan of the ribs and a subsequent consultation with a rheumatologist.

Which doctor treats costocartilaginous syndrome: If you have symptoms of Tietze’s syndrome, you should first consult a rheumatologist, based on the results of the initial examination, the doctor may prescribe an additional consultation with an orthopedist.

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Tietze’s syndrome is a rare condition that causes chest pain in the upper ribs. It is a benign disease that mainly affects patients under the age of 40. The exact cause of its occurrence is unknown.

Costochondral syndrome symptoms

The main symptom of Tietze’s syndrome is chest pain. In this condition, pain is felt around one or more of the 4 upper ribs, especially where the ribs attach to the sternum. In 70-80% of cases, the pain is localized around one rib. Usually only one side of the chest is affected. Inflammation of the cartilage of the affected rib causes pain and swelling. The area may hurt, look swollen, or red. Tietze syndrome pain can:

• come on suddenly or gradually
• be sharp, stabbing, blunt or painful
• vary from weak to strong
• extend to arm, neck and shoulders
• aggravated by exertion, coughing or sneezing.

Causes of Tietze’s syndrome

The exact cause of Tietze’s syndrome is unknown. However, researchers believe that it may be the result of a minor injury to the ribs. Injuries caused:

• severe cough
• violent vomiting
• upper respiratory infections, including sinusitis or laryngitis
• strenuous or repetitive physical activity
• injuries or wounds.

Risk factors

The biggest risk factors for Tietze syndrome are age and possibly season. Tietze’s syndrome mainly affects children and patients under the age of 40. The number of cases is higher in winter and spring. The syndrome develops most often in women, but can also affect men.

How Tietze’s syndrome differs from costochondritis

Tietze’s syndrome and costochondritis cause chest pain around the ribs, but there are important differences:

Diagnosis of Costochondral Syndrome

Tietze’s syndrome is difficult to diagnose, especially when it is necessary to distinguish it from the more common costochondritis. During your initial appointment, your doctor will perform an orthopedic examination and ask you about your symptoms. He will prescribe certain tests to rule out other causes and make the correct diagnosis. These include:

• blood test to check for signs of a heart attack or other disease
• Ultrasound to check ribs for cartilage inflammation
• X-ray of the ribs to detect diseases associated with organs, bones and tissues
• Chest MRI to look more closely at cartilage thickening or inflammation
• CT fins
• electrocardiogram.

Treatment

General treatment regimen for Tietze’s syndrome:

• rest
• avoidance of strenuous activity
• applying heat to the affected area.

In some cases, the pain resolves on its own without treatment. For relief, the doctor will recommend painkillers. Other possible treatments for ongoing pain and inflammation include steroid injections to reduce swelling, or injections of lidocaine into the affected area to relieve pain. Tietze’s syndrome pain usually improves within a few months. Sometimes the condition improves and then resume. In extreme cases where conservative treatments fail to reduce pain and swelling, surgery is required to remove excess cartilage from the affected ribs.

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Author: Viktor Evgenievich Tolnikov

Specialization: Orthopedist, Traumatologist, Sports doctor Harmful

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