costochondritis(idiopathic)

Last reviewed 01/2018

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.