Tietze syndrome refers a benign costochondritis accompanied by hypertrophy of the costal cartilages.
The exact incidence of occurrence is not known. It is seen most commonly in the 2nd to 5th decades of life. Both sexes are affected equally.
It is characterised as a tender, non-suppurative swelling in the upper costosternal region. It can have an acute or gradual onset and may resolve spontaneously. It may mimic a myocardial infarction, but the pain in Tietze syndrome is more localised and is not accompanied by any additional presenting symptoms.
Chest wall MRI
MRI features of Tietze's syndrome were characterised according to one study as follows 1:
- enlargement and thickening of cartilage at the site of the complaint
- focal or widespread increased signal intensities of affected cartilage on both TSE T2-weighted and STIR/T2 fat-saturated images
- bone marrow oedema in the subchondral bone
- intense gadolinium enhancement in the areas of thickened cartilage, in the subchondral bone marrow, and/or in the capsule and ligaments
Ga-67 imaging often shows increased radiotracer uptake 7.
History and etymology
First described in 1921 by Alexander Tietze (1864-1927), a German surgeon.
Treatment and prognosis
It is a benign condition that may subside spontaneously. Some authors suggest local steroid injection as a possible treatment option 6.
The differential diagnosis of Tietze syndrome runs the gamut of musculoskeletal chest wall pain, as well as:
- 1. Volterrani L, Mazzei MA, Giordano N et-al. Magnetic resonance imaging in Tietze's syndrome. Clin Exp Rheumatol. 2009;26 (5): 848-53. Pubmed citation
- 2. Martino F, D'Amore M, Angelelli G et-al. Echographic study of Tietze's syndrome. Clin. Rheumatol. 1991;10 (1): 2-4. Pubmed citation
- 3. Aeschlimann A, Kahn MF. Tietze's syndrome: a critical review. Clin. Exp. Rheumatol. 1990;8 (4): 407-12. Pubmed citation
- 4. Kamel M, Kotob H. Ultrasonographic assessment of local steroid injection in Tietze's syndrome. Br. J. Rheumatol. 1997;36 (5): 547-50. Pubmed citation
- 5. Jurik AG, Justesen T, Graudal H. Radiographic findings in patients with clinical Tietze syndrome. Skeletal Radiol. 1988;16 (7): 517-23. Pubmed citation
- 6. Kamel M, Kotob H. Ultrasonographic assessment of local steroid injection in Tietze's syndrome. Br J Rheumatol. 1997;36 (5): 547-50. Pubmed citation
- 7. Honda N, Machida K, Mamiya T et-al. Scintigraphic and CT findings of Tietze's syndrome: report of a case and review of the literature. Clin Nucl Med. 1989;14 (8): 606-9. Pubmed citation