Costochondritis & Tietze's Syndrome

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What is costochondritis?

Costochondritis is a common form of inflammation of the cartilage where ribs attach to the breastbone, the sternum. The inflammation can involve multiple cartilage areas on both sides of the sternum but usually is on one side only.

What causes costochondritis?

The causes of costochondritis are not known and may involve several factors. Possible causes include heredity (genetic predisposition), viruses, and trauma (injury).

Costochondritis can be an independent condition by itself or sometimes can be a feature of a more widespread disorder. Examples of illnesses that can feature costochondritis include fibromyalgia, psoriatic arthritis, ankylosing spondylitis, reactive arthritis, rheumatoid arthritis, lupus, and inflammatory bowel disease (such as ulcerative colitis and Crohn's disease).

What are symptoms of costochondritis, and what is Tietze's syndrome?

Costochondritis is distinguished from Tietze's syndrome, a condition also involving the same area of the front of the chest, by the presence of swelling. Costochondritis is not associated with swelling, as opposed to Tietze's syndrome, where swelling is characteristic. Tietze's syndrome is an inflammation of the costochondral cartilages of the upper front of the chest that involves swelling of the joint.

While both costochondritis and Tietze's syndrome feature localized pain and tenderness in the front of the chest, Tietze's syndrome also causes swelling over the ribs and cartilage near the breastbone (sternum). Redness, tenderness, and warmth can also be present, but a localized swelling is the distinguishing finding. The pain is variable, often sharp, can be confused with heart pain, and can last from hours to weeks. It can cause difficulty with sleeping and even rolling over in bed is sometimes painful. Blood testing (sedimentation rate or C-reactive protein test) can show signs of inflammation in patients with Tietze's syndrome, whereas patients with costochondritis alone typically have normal tests for inflammation.

Reviewed by John P. Cunha, DO, FACOEP on 9/13/2012


Patient Comments

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Costochondritis and Tietze's Syndrome - Treatments Question: What was the treatment for your costochondritis and Tietze's syndrome?
Costochondritis and Tietze's Syndrome - Symptoms Question: What symptoms did you experience with your costochondritis and Tietze's syndrome?

What causes costochondritis? Is there anything that aggravates it (like exercise or diet), or is it possibly viral?

Medical Author: William C. Shiel Jr., MD, FACP, FACR

Costochondritis can be aggravated by any activity that involves stressing the structures of the front of the chest cage. It is generally best to minimize these activities until the inflammation of the rib and cartilage areas has subsided.

I am unaware of any particular diet causing worsening of costochondritis. On the contrary, it is known that fish oilscan have a degree of antiinflammation effect. Theoretically they could be of some benefit. This effect is probably minor, however.

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