Costochondritis & Tietze Syndrome

Costochondritis is reproducible tenderness at the costochondral or costosternal junctions without swelling, and one of the most common musculoskeletal causes of anterior chest pain.

Tietze syndrome is much less common: painful, visible swelling at a single upper junction, usually the 2nd or 3rd, in younger adults.

Both are diagnosed only once cardiac, pulmonary and other serious causes have been considered and excluded. Both are usually self-limiting and managed conservatively in primary care.

The anterior chest wall is formed by the sternum, costal cartilages and ribs. Costochondral junctions are cartilaginous joints with no joint cavity; the 2nd to 7th costosternal joints are synovial and can develop synovitis.

Costochondritis is more common in women. Triggers include a prolonged cough after a respiratory infection, repetitive upper-body loading, a new training load and postural strain.

Tietze syndrome is thought to be inflammatory and is often preceded by a respiratory infection or strain.