Tietze’s syndrome: significance of differential diagnosis in rheumatic diseases

Abstract

Tietze’s syndrome was first described in 1921 as a cause of chest pain. It can be defined as a benign, painful, non-suppurative localized swelling of the costosternal（most often involving the second or the third rib）or the sternoclavicular joints, in the absence of other evident causes which could be responsible for this syndrome. Reports on painful inflammatory episodes involving particularly the Tietze’s area and the sternoclavicular region have addressed differentiating between sternoclavicular hyperostosis and rheumatoid arthritis, arthritis associated with palmoplantar-pustulosis, severe acne, psoriasis, reactive arthritis（Reiter’s syndrome）, ankylosing spondylitis, Crohn’ disease, and ulcerative colitis, etc. The purpose of this review is to re-evaluate the importance of Tietze’s syndrome in the differential diagnosis of chest pain, taking into account knowledge on rheumatic diseases affecting the anterior chest wall.