Tietze syndrome is a rare condition that causes pain in the middle of the chest and swelling around the ribs. The symptoms may become more noticeable when coughing or taking a deep breath.
The exact cause of Tietze syndrome is unknown. However, it may be associated with chest trauma, psoriatic arthritis, surgery in the area, or excessive coughing or vomiting.
Symptoms usually improve without specific treatment. However, an orthopedist may recommend rest, warm compresses, or pain-relieving medication to ease discomfort while the inflammation improves.
Main symptoms
The main symptoms of Tietze syndrome are:
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Pain in the sternum, in the middle of the chest
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Increased tenderness around the ribs
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Swelling around the ribs due to inflammation of the cartilage in the area
Tietze syndrome symptoms occur in the upper part of the chest and may spread to the shoulder and arm. They may be triggered or worsened by coughing or taking a deep breath.
Tietze syndrome vs costochondritis
Unlike Tietze syndrome, costochondritis does not cause localized swelling around the ribs. According to the American Academy of Family Physicians, it is also more common and typically causes pain in the middle of the chest that worsens with breathing, coughing, or movement.
Confirming a diagnosis
Tietze syndrome is initially diagnosed by an orthopedist based on an evaluation of the person’s signs and symptoms.
However, to rule out other conditions that can also cause chest pain, the doctor may order a chest X-ray, CT scan, MRI, or electrocardiogram (ECG).
Possible causes
The causes of Tietze syndrome are not yet fully understood. However, it is believed that the condition may result from minor injuries to the chest or may be associated with psoriatic arthritis.
Tietze syndrome may also be associated with excessive coughing or vomiting, a bacterial infection, surgery involving the chest, or a significant injury to the chest area.
Treatment options
In general, Tietze syndrome does not require specific treatment because the symptoms and inflammation usually improve over time.
According to the American Academy of Family Physicians, Tietze syndrome is usually self-limiting and can generally be managed with simple pain relievers. A healthcare provider may also recommend rest, avoiding strenuous activities, and applying a warm compress to the affected area.
In rare or persistent cases, the provider may recommend a corticosteroid injection to reduce inflammation and relieve pain and/or a local anesthetic nerve block to help relieve symptoms.