Tietze's syndrome

Infobox_Disease
Name = Costochondritis

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Caption = Sternocostal and interchondral articulations. Anterior view. (Costal cartilages visible on diagram.)
DiseasesDB = 13112
ICD10 = ICD10|M|94|0|m|91
ICD9 = ICD9|733.6
ICDO =
OMIM =
MedlinePlus =
eMedicineSubj =
eMedicineTopic =
MeshID = D013991

Tietze's syndrome, is a benign inflammation of one or more of the costal cartilages. It was first described in 1921 by the German surgeon Alexander Tietze (1864-1927). [WhoNamedIt|synd|2640] [A. Tietze. Über eine eigenartige Häufung von Fällen mit Dystrophie der Rippenknorpel. Berliner klinische Wochenschrift, 1921, 58: 829-831.]

Tietze's is not the same thing as costochondritis, the sole difference being that in Tietze's syndrome there is swelling of the costal cartilages. It is now recognized that the presence or absence of swelling is only an indicator of the severity of the condition. It was at one time thought to be associated with, or caused by, a viral infection acquired during surgery, but this is now known not to be the case. Most sufferers have not had recent surgery.

It should not be confused with Tietz syndrome.

Presentation

The primary presentation of the syndrome is significant, acute pain in the chest, along with tenderness and some swelling of the cartilages affected, which is commonly palpable on examination. Although many times it can be extremely painful, to the point of being debilitating, Tietze's Syndrome is considered to be a benign condition that generally resolves in 12 weeks. However, it can often be a chronic condition.Perceived pain is often exacerbated with respiration.

Costochondritis symptoms are similar to the Tietze's, prime difference being that the pain radiates to the arms and shoulders in the latter.

If the pain does not completely cease within two months, it is recommended the patient consult with a doctor.

Cause

While the true causes of Tietze's Syndrome are not well understood, it often results from a physical strain or minor injury, such as repeated coughing, vomiting or impacts to the chest. It has even been known to occur after hearty bouts of laughter. It can occur by over exertingor by an injury in the chest and breast.

Psychological stress is also a cause of Tietze's Syndrome. Preceding stressful events such as relationship problems, family issues or work related stress are very commonly associated with this syndrome.

Differential diagnosis

Although patients will often mistake the pain of Tietze's Syndrome for a myocardial infarction (heart attack), the syndrome does not progress to cause harm to any organs.

It is important to rule out a heart attack, as the symptoms can be similar. After examination, doctors often reassure patients that their symptoms are not associated with a heart attack, although they may need to treat the pain, which in some cases can be severe enough to cause significant but temporary disability to the patient.

There is pain and discomfort in the chest wall of the patient. The pain is generally at night and in the morning, however it can affect you at any time of day. The pain usually subsides in five (5) to six (6) hours. The patient must not move or exert during pain. The patient should lie down and lightly massage the affected area.

Alternative Cures

Supplements, including ginger root, evening primrose oil, bromelain, vitamin E, omega-3 oils, and white willow bark, may be used to reduce the inflammation. In addition, substances that may promote the healing of cartilage, such as glucosamine/chondroitin sulphate, may also be used. Acupuncture and massage therapy may also be useful. [http://www.healthatoz.com/healthatoz/Atoz/common/standard/transform.jsp?requestURI=/healthatoz/Atoz/ency/costochondritis.jsp]

References

External links

* [http://orthopedics.about.com/cs/sprainsstrains/a/costochondritis.htm Overview] at About.com
* [http://www.netdoctor.co.uk/diseases/facts/costochondritis.htm NetDoctor]
* [http://www.mayoclinic.com/health/costochondritis/DS00626 Overview] at Mayo Clinic
* [http://www.medicinenet.com/costochondritis_and_tietze_syndrome/article.htm Constochondritis and Tietze Syndrome]