Tietze syndrome
| Classification according to ICD-10 | |
|---|---|
| M94.0 | Tietze syndrome |
| ICD-10 online (WHO version 2019) | |
When Tietze Syndrome , Chondroosteopathia costal , Crohn Tietze , is a rare and pressure painful swelling of unknown cause that usually in the range of the sternum approach the 2nd or 3rd rib occurs and heals again within months. There is no evidence of inflammation .
Erstbeschreiber was Alexander Tietze (1864-1927) with his 1921 published work "About a rare cluster of cases with dystrophy of the rib cartilage" in Berlin clinical weekly .
The syndrome should not be confused with Tietz syndrome , an albinism with deafness .
frequency
Occurrence in children is possible. The six cases in Zambia described by Gill were between 23 and 38 years old. An accumulation in older age without emphasizing gender differences is repeatedly stated in the literature. It has to be taken into account that people of the age at which coronary artery disease is more likely and a corresponding concern more understandable are more often carefully examined and only then does Tietze syndrome receive scientific attention.
Affected people present themselves to the private practice area or the emergency room of a hospital because they fear a cardiac cause of their symptoms. After all, it is assumed that up to 30% of all emergency admissions due to chest pain can be traced back to “musculoskeletal chest pain” or “chest wall pain” . The prevalence of Tietze syndrome itself is too low to be able to provide more precise information here.
diagnosis
The Tietze syndrome must be differentiated from other less precisely defined musculoskeletal pain in the chest wall, which is known as costochondritis or costosternal syndrome and does not show any swelling, reddening or overheating. The differentiation from angina pectoris as a symptom of coronary heart disease is easy due to the swelling, reddening and spatially circumscribed, reproducible tenderness to pressure without radiation. As a rule, a simple physical examination and a subsequent discussion are sufficient to calm the patient down.
However, there are isolated case reports in the medical literature in which other serious diseases such as cancer or tuberculosis have hidden behind the image of "Tietze syndrome".
therapy
There are no reliable clinical studies on the effectiveness of various therapy options. The quick diagnosis and explanation of the facts contribute significantly to the improvement of the symptoms. Anti-inflammatory pain relievers (NSAIDs) as topical application or in tablet form are also part of symptomatic treatment, as is infiltration with a local anesthetic such as lidocaine . An unsatisfactory effect of NSAIDs and rapid effect of a single infiltration are mentioned several times in the medical literature.
The prognosis is good. No lasting complaints are to be expected.
Individual evidence
- ↑ GEO thematic dictionary. Volume 11: Medicine and Health: Diagnosis, Healing Art, Medicines. Part: Ok – Z. ISBN 3-7653-9431-9 .
- ↑ A. Tietze: About a strange accumulation of cases with dystrophy of the costal cartilage. In: Berlin clinical weekly. 1921, 58, pp. 829-831.
- ↑ M. Mukamel, L. Kornreich, G. Horev, A. Zeharia, M. Mimouni: Tietze's syndrome in children and infants. In: J Pediatr. 1997 Nov; 131 (5), pp. 774-775. PMID 9403667
- ^ GV Gill: Epidemic of Tietze's syndrome. In: British Medical Journal . Volume 2, number 6085, August 1977, p. 499, ISSN 0007-1447 . PMID 890368 . PMC 1630913 (free full text).
- ↑ J. Freeston, Z. Karim, K. Lindsay, A. Gough: Can early diagnosis and management of costochondritis reduce acute chest pain admissions? In: J Rheumatol . 2004 Nov; 31 (11), pp. 2269-2271. PMID 15517642
- ↑ R. Cocco, P. Galieni, C. Bellan, A. Fioravanti: Lymphomas presenting as Tietze's syndrome: a report of 4 clinical cases. In: Ann Ital Med Int. 1999 Apr-Jun; 14 (2), pp. 118-123. PMID 10399374
