CHEST PAIN, COSTOCHONDRITIS AND TIETZE SYNDROME

Costochondritis is a chest wall pain caused by inflammation of the costal cartilage or the area where the ribs meet the sternum, known as sternal articulations.

 It is associated with multiple ribs typically ranging from 2 to 5, and is not associated with localized swelling over the affected joints. 

It is a benign cause of chest pain. Patients often present with the chief complaint of chest pain; therefore, other causes of chest pain must be excluded with history, physical exam, and/or diagnostic testing prior to a diagnosis of costochondritis.

Tietze Syndrome is an atypical cause of anterior chest pain characterized by localized tenderness and non-suppurative swelling, usually associated with the 2nd or 3rd costal cartilages unilaterally. 

This condition is benign and self-limiting, with most patients experiencing complete relief of pain and swelling within weeks to months while utilizing conservative symptomatic treatment modalities.  

It is most commonly misdiagnosed as costochondritis, as the latter also presents as anterior chest wall pain that is reproduced with palpation at the sternochondral and costochondral junctions. 

Chest pain appears in many forms, ranging from a sharp stab to a dull ache. Sometimes chest pain feels crushing or burning. In certain cases, the pain travels up the neck and into the jaw and then spreads to the back or down one or both arms. 

The most life-threatening causes involve the heart or lungs.

 If you have new or unexplained chest pain or think you have a heart attack, call 911 (US), OR call 112 (Europe and parts of Asia).