Tietze syndrome is a rare, inflammatory disorder characterized by chest pain and swelling of the cartilage of one or more of the upper ribs (costochondral junction), specifically where the ribs attach to the breastbone (sternum).
Tietze syndrome is characterized by mild to severe localized pain and tenderness in one or more of the upper four ribs. The second or third ribs are most often affected. In most people, the cartilage of only one rib is affected. A firm, spindle-shaped swelling occurs in the cartilage of the affected rib. An aching, gripping, sharp, dull, or neuralgic pain occurs in this area. Sometimes, the pain may spread to affect the neck, arms and shoulders. Redness (erythema) and warmth of the affected area may be present.
The onset of pain may be gradual or sudden, and can vary in intensity. The pain associated with Tietze syndrome may worsen due to sneezing, coughing, or strenuous activity or exercise.
The exact cause is not known (idiopathic). Some researchers have speculated that multiple microtrauma to the anterior chest wall may cause the development of Tietze syndrome. Sometimes, the development of the disorder may be preceded by chronic, excessive coughing, vomiting, trauma or impact to the chest, viral or bacterial infections, or surgery to the thoracic area.