Tietze Syndrome

Tietze syndrome is a disease in which an inflammatory process where the joints that unite the ribs with the sternum develops. These structures are called costochondral joints (or union of the ribs with their costal cartilage). This disorder also affects the soft tissues that are nearby.

This type of illness was considered rare because it appeared infrequently in the population. It has been shown that it mostly occurs in patients between 20 to 40 years old, but it can also develop at any age. It has a close relationship with costochondritis, a condition in which the cartilage of the ribs is inflamed.

Normally, patients suffering from Tietze syndrome may experience a series of alterations. For example, among the most frequent symptoms, we find sensitivity to heat, redness, increased pressure in the affected area, swelling or enlargement of the region between the ribs and the sternum and pain that is usually located between the fourth and sixth rib to the left of the sternum. This pain may have different levels of intensity. Sometimes, this discomfort is so strong that it can even be confused with a heart attack. This sensation can radiate to other nearby areas such as the abdomen or shoulders. In any case, the discomfort worsens when the patient executes a series of physical activities involving the thorax, for example, breathing deep, sneezing, sudden movements of the arms, etc.

Currently, the cause of this illness remains unknown. However, several clinical studies have been able to identify a series of risk factors. Among the possible triggers of this alteration are:

  • Some types of traumas of the thorax such as a fall or a car accident, among many others.

  • Repetition of movements that involve the chest area such as coughing. This could cause the progressive wear and tear of the cartilage involved and its subsequent inflammation.

  • Performing intense physical exercises such as lifting heavy objects. It can also damage already weakened cartilage.

  • Presence of tumors in the sternochondral joints.

  • Certain types of rheumatism.

  • Development of some diseases that may affect cartilage, like tuberculosis.

The doctor or specialist will carry out a series of medical procedures to detect the disease. Thus, specialists can identify this disorder easily and discard others with similar characteristics. The most commonly used tests to achieve these objectives are:

  • A physical exam: The doctor can check the symptoms that the patient presents related to Tietze syndrome. Also, a study of your medical history and background will assist in a proper diagnosis.

  • Internal imaging tests. With these, the doctor will analyze the thickening of the cartilage caused by the inflammation that it suffers. Commonly, radiography and magnetic resonance (MRI) are used.

  • Routine tests such as blood and urine tests.

  • An electrocardiogram (EKG)

  • A biopsy

In a patient with symptoms like chest tightness, it is always necessary to make a differential diagnosis that includes Tietze syndrome. It is rare, but sometimes the characteristic pain of this pathology can simulate the ischemic pain of cardiovascular origin. The most frequent etiology in this case is acute myocardial infarction and angina pectoris. If the ischemia is compensated, the angina can resemble the inflammation that is typical of Tietze syndrome.

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