Tietze's syndrome: case report and literature review

Abstract

The case report is on Tietze's syndrome – a disorder that is quite rare. Costochondritis has been thought to be synonymous with Tietze's syndrome until recently [2002] when costochondritis was differentiated from Tietze's syndrome. Costochondritis is inflammation of the costochondral joints without swelling. Tietze's syndrome, on the other hand, implies swelling and tenderness at the costochondral joints with an insidious onset of pain. This is a report of the case of a middle-aged man with an insidious onset of pain, swelling and tenderness over the 2^nd left costochondral joint. A chest X-ray was done and reported as normal. He also had a full blood count, which showed a leucocytosis with normal differential count. His erythrocyte sedimentation rate (ESR) was raised. The diagnosis of Tietze's syndrome was made on exclusion based on the presence of pain, swelling and tenderness over the costochondral joint as the investigations did not support any other diagnosis. He was placed on a non-steroidal anti-inflammatory drug [Ibuprofen] and his pain subsided completely within four weeks, and his swelling resolved within eight months.

Keywords: Tietze's syndrome, costochondritis, differential diagnosis, myocardial infarction, non-steroidal anti-inflammatory drugs (NSAID)

Journal of Medicine in the Tropics Vol. 7(2) 2005: 26- 31