Tietze Syndrome

This article contains self-care information for the selected condition. If you have questions or need more comprehensive treatment advice, please consult a medical professional.

Tietze syndrome is a relatively rare condition that causes localized pain and swelling of the cartilage of one or more of the upper ribs (upper front of the chest). 1

The symptoms are usually mild. However, pain may get worse during physical activity or when taking a deep breath, coughing, or sneezing.

Teenagers and young adults under the age of 40 are the most commonly affected.

Diagnosis is usually based on a physical examination. Other medical imaging tests may be needed to rule out other causes of pain and swelling.

Treatment normally involves rest and mild painkillers. In more severe cases, an injection of local anesthetic or steroids may be needed. The symptoms usually go away after 1 to 2 weeks, and most people recover completely without further complications.

If you think you or a beloved one may be experiencing symptoms of Tietze Syndrome, try the free Ada app for a quick health assessment.

The cause of Tietze syndrome is not well understood. One of the possible reasons is small injuries, known as microtraumas, causing damage or swelling to the ribs. 1 2 3.

These minor injuries can come from:

• Chronic trauma: frequent coughing, sneezing, or vomiting
• Acute trauma: Strenuous activities during sports, exercise, or accidents.

The condition most commonly affects teenagers and young adults under 40 years of age. However, it can affect older and younger people as well 3 4.

Symptoms of Tietze syndrome may include:

• Pain
• Tenderness
• Swelling
• Redness or warmth

These symptoms most commonly affect the second or third upper ribs. It's often possible with Tietze Syndrome to feel a lump on the chest. The pain may further extend to the neck, shoulders, or upper arms. 2 3

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To establish the diagnosis of Tietze syndrome, other conditions that cause pain and swelling at the upper front chest may need to be ruled out first. 5 3 4 Doctors will have to take the person’s medical history and conduct a physical examination to identify the characteristics of the symptoms first.

Furthermore, several tests such as electrocardiogram, medical imaging tests (e.g., X-ray, CT or MRI scans) or biopsies may be necessary to assess the extent of the symptoms and to exclude other causes. 6 Given that soft tissue swelling (a lump) is one of the hallmarks of Tietze syndrome, an ultrasound can be one of the most effective tools to assist in the diagnosis. 2

The most common differential diagnosis of Tietze Syndrome is costochondritis as they both present with front upper chest wall pain and discomfort. The pain in Tietze syndrome is usually localized within a smaller area and accompanied by swelling, whereas costochondritis usually presents as pain in multiple ribs without swelling around the damaged joints. 3 4

The treatment of Tietze Syndrome aims to alleviate the pain and usually depends on the severity of discomfort. 2 3 4

• Mild: symptoms are normally tolerable and can improve with rest.
• Moderate: if the pain becomes intolerable, taking painkillers such as acetaminophen or non-steroidal anti-inflammatory drugs (e.g. aspirin, ibuprofen), or applying heat or an ice pack as directed by the doctors may be helpful.
• Severe: if painkillers are ineffective, an injection of local anesthetic or steroids may be needed.

Generally speaking, the symptoms of Tietze syndrome go away after 1 or 2 weeks. Most people recover well without further complications. The long-term outlook is usually good without any complications. 2