Tietze syndrome: Signs, Symptoms, Causes, Diagnosis and Treatment

A German doctor first named him at the beginning of the 20th century. Now it is recognized that the presence of the swelling is only an indicator of the severity of the condition.

Tietze’s syndrome causes pain and tenderness on the sternum and ribs, often mistaken for a heart attack.

This condition and the Costosternal Syndrome, also known as Costochondritis, were initially described as two different diseases, with the only difference being the amount of swelling of the costal cartilages.

Breast pain is commonly caused by this syndrome poorly understood and generally poorly managed. It can also affect the joint between the clavicle and the sternum; the joint is called sternoclavicular in anatomical terms.

Pain in the chest is commonly caused by a joint sprain between the rib and the sternum. It is usually associated with discomfort along the rib and in the middle, but this is not necessarily the case.

You can quickly assess Tietze’s syndrome yourself; Press firmly on the sternum and then slide the fingers to the right and left over the joint with the rib and between the ribs.

It will be susceptible in some of the joints if it has it, usually on one side, more commonly on the left, but it can be bilateral.


It is almost certain that you do not have a heart attack, although this should always be considered. His name is the external cost syndrome or Tietze; in its mild form, it is pretty standard. Deep breathing can aggravate pain, but generally not unless it is serious.

Signs and symptoms

When the costochondral joint becomes inflamed, it can cause acute pain in the chest and tenderness, developing gradually or starting suddenly. The pain may be worsened by:

  • A particular posture, like lying down.
  • Pressure on your chest, like wearing a seatbelt or hugging someone.
  • Deep breathing, coughing and sneezing.
  • Physical activity.

When to Search for Medical Help

It can be challenging to distinguish between chest pain associated with Tietze’s syndrome and pain caused by more severe conditions, such as a heart attack.

However, a heart attack usually causes more widespread pain and additional symptoms, such as shortness of breath, nausea, and sweating.

If you, or someone you are with, experience sudden pain in your chest and think there is a possibility of a heart attack, call immediately and request an ambulance.

If you have had chest pain for a while, do not ignore it. Please make an appointment to see your GP so they can investigate the cause.

Causes of Tietze’s syndrome

Inflammation is the body’s natural response to infection, irritation, or injury. It is not known precisely why the costochondral joint is inflamed, but in some cases, it has been related to:

  • Strong cough, which affects the area of ​​your chest.
  • An injury to your chest
  • Physical exertion for repeated exercise or sudden effort to which you are not accustomed, such as moving furniture.
  • An infection, including respiratory tract infections and wound infections.

Diagnosis of Tietze’s syndrome

The diagnosis of costochondritis is based on personal history and physical examination. There are no specific tests for Costochondritis.

The investigations are mainly aimed at ruling out the fatal causes of chest pain, such as angina or heart attack. These may include:

  • A chest x-ray is one of the most cost-effective investigations available to discover the cause of chest pain.
  • Gallium scintigraphy is a more sophisticated imaging study to detect infections. The infected areas show a more excellent absorption of the radioactive material of gallium.
  • Blood tests are also valuable. The increase in the white blood cell count could mean an infection.
  • The electrocardiogram is routinely ordered to rule out heart disease.

If the doctor does not suspect or does not find another condition, a diagnosis can be made of Tietze’s syndrome.

Treatment of Tietze’s syndrome

Tietze’s syndrome often improves after a few weeks, but self-help measures and medications can control symptoms.

Self-help:  Tietze’s syndrome can be aggravated by any activity that puts pressure on your chests, such as strenuous exercise or even simple movements such as reaching a high cabinet.

Any activity that worsens the pain in the area of ​​your chest should be avoided until the inflammation in the ribs and cartilage has improved. You can also find it soothing to apply heat regularly to the painful area, for example, using a cloth or flannel that has been heated with hot water.

Analgesics:  Analgesics, such as paracetamol, may relieve mild to moderate pain. Taking a non-steroidal anti-inflammatory medication, such as ibuprofen and naproxen, two or three times a day can also help control pain and swelling.

Aspirin is also an appropriate alternative, but it should not be given to children under 16. These medications are available in pharmacies without a prescription, but you should carefully read the instructions that come with them before use.

Contact your doctor if your symptoms worsen despite resting and taking painkillers, as you may benefit from corticosteroid treatment.

Corticosteroid injections: Corticosteroids are powerful medications that can help reduce pain and swelling. They can be injected into and around your costochondral joint to help relieve the symptoms of costochondritis.

Corticosteroid injections may be recommended if your pain is severe; your GP may be able to administer them or refer you to a specialist called a rheumatologist.

Having too many injections of corticosteroids can damage the costochondral joint, so you can only receive this type of treatment for Tietze’s Syndrome once every few months if you continue to experience pain.