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Costochondritis / Tietzes-Syndrome
Definition: Costochondritis, Tietzes-syndrome is a non-malignant inflammation of one ore more of the costochondral joints.
Causes: Tietzes syndrome is different to costochondritis in that the former presents with swelling of the costal cartilages, whereas the latter doesn't. The degree of swelling is only indicative of the severity of the disease.
The exact aetiology of costochondritis is poorly understood. The condition is associated with a form of physical injury or strain, such as prolonged coughing/sneezing, shouting, vomiting and impacts to the thoracic cage. There is also a strong association with radiation therapy to the chest area.
Examination: The most important consideration in diagnosing costochondritis is to clinically exclude any more sinister pathologies such as myocardial infarctions and osseous tumours.
Observation: The patient will present with pain over the costochondral articulations aggravated by deep inhalation coughing, and direct pressure.
Palpation: Advanced Tietzes syndrome can present as tender, inflamed palpable nodules over the costochondral articulations.