Costochondritis and Tietze's Syndrome

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

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

  • Medical Editor: John P. Cunha, DO, FACOEP
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

What are signs and symptoms of costochondritis and Tietze's syndrome?

Costochondritis is distinguished from Tietze's syndrome, a condition also involving pain in the costosternal joint, 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 symptoms such as localized chest pain and tenderness, Tietze's syndrome also causes swelling over the ribs and cartilage near the breastbone (sternum). Signs and symptoms such as redness, tenderness, and warmth can also be present, but a localized swelling is the distinguishing finding. The chest pain is variable, often sharp, can be confused with heart pain or heart attack, 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.

What health care specialists aid in the diagnosis and treatment of costochondritis and Tietze's syndrome?

Primary-care doctors, including family medicine doctors, general practitioners, and internists, as well as rheumatologists (medical specialists in musculoskeletal disease and systemic autoimmune conditions) and orthopedists (medical specialists in disorders of the musculoskeletal system) are all health care professionals who aid in the diagnosis and treatment of costochondritis and Tietze's syndrome. If a patient goes to an emergency room with chest pain, he or she will see an emergency medicine doctor.

What medical exams and tests do health care professionals use to make a diagnosis of costochondritis and Tietze's syndrome?

Doctors diagnose costochondritis and Tietze's syndrome based on the typical history of chest pain localized to the cartilage adjacent to the breastbone as well as the examination findings of tenderness. Swelling is also noted in patients with Tietze's syndrome.

Medically Reviewed by a Doctor on 9/7/2016

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