Tietze’s Syndrome in the emergency department: A rare etiology of atraumatic chest pain
Affiliation(s)
Department of Emergency Medicine, State University of New York, Downstate Medical Center, New York, USA;. Department of Emergency Medicine, Long Island Jewish Medical Center, New York, USA.
Department of Emergency Medicine, State University of New York, Downstate Medical Center, New York, USA;. Department of Emergency Medicine, Long Island Jewish Medical Center, New York, USA.
ABSTRACT
Tietze’s Syndrome is an uncommon disorder that presents with painful, tender, non-suppurative swelling of the anterior chest wall. We report a case of a female patient who presented to the emergency department with a chief complaint of atraumatic chest pain and swelling of the anterior chest wall. After a thorough history and physical examination, as well as basic laboratory tests and chest radiography, she was diagnosed with Tietze’s Syndrome. The expedient accurate diagnosis of Tietze’s Syndrome is important for the physical and emotional well-being of a patient, and avoids overlooking more dangerous pathologies. Tietze’s Syndrome needs to be considered in the differential diagnosis of a patient presenting with spontaneous swelling of the anterior chest.
Cite this paper
Grodin, L. and Farina, G. (2013) Tietze’s Syndrome in the emergency department: A rare etiology of atraumatic chest pain. Case Reports in Clinical Medicine, 2, 208-210. doi: 10.4236/crcm.2013.23056.
Grodin, L. and Farina, G. (2013) Tietze’s Syndrome in the emergency department: A rare etiology of atraumatic chest pain. Case Reports in Clinical Medicine, 2, 208-210. doi: 10.4236/crcm.2013.23056.
References
[1] Gijsbers, E. and Knaap, S.F. (2011) Clinical presentation and chiropractic treatment of Tietze Syndrome: A 34-year-old female with left-sided chest pain. Journal of Chiropractic Medicine, 10, 60-63. doi:10.1016/j.jcm.2010.10.002 [2] Hiramuro-Shoji, F., Wirth, M.A. and Rockwood Jr., C. (2003) Atraumatic conditions of the sternoclavicular joint. Journal of Shoulder and Elbow Surgery, 12, 78-88. doi:10.1067/mse.2003.128566 [3] Wolf, E. and Stern, S. (1976) Costosternal Syndrome: Its frequency and importance in differential diagnosis of coronary heart disease. Archives of Internal Medicine, 136, 189-191. doi:10.1001/archinte.1976.03630020043010 [4] Tietze, A. (1921) über eine eigenartige häufung von fällen mit dystrophie der rippenknorpel. Berliner Klinische Wochenschrift, 58, 829-831. [5] Rare Diseases and Related Terms, National Institutes of Health (2013). http://rarediseases.info.nih.gov/RareDiseaseList.aspx?PageID=1. [6] Aeschlimann, A. and Kahn, M.F. (1990) Tietze’s Syndrome: A critical review. Clinical and Experimental Rheumatology, 8, 407-412. [7] Jelenko, C. and Cowan, G. (1977) Perichondritis (Tietze’s Syndrome) at the xiphisternal joint: A mimic of severe disease. Journal of the American College of Emergency Physicians, 6, 536-542. doi:10.1016/S0361-1124(77)80424-3 [8] Epstein, S.E., Gerber, L.H. and Borer, J.S. (1979) Chest wall syndrome: A common cause of unexplained cardiac pain. The Journal of the American Medical Association, 26, 2793-2797. doi:10.1001/jama.1979.03290520017017 [9] Mukamel, M., Kornreich L., Horev, G., Zebria, A. and Mimouni, M. (1997) Tietze’s Syndrome in children and infants. Journal of Pediatrics, 131, 774-775. doi:10.1016/S0022-3476(97)70114-8 [10] Pikning, J.M., De Boeck, H. Desprechins, B. and Ernst, C. (2003) Tietze’s Syndrome in a 2-year-old boy. Nederlands Tijdschrift Geneeskunde, 43, 2134-2136. [11] Volterrani, L., et al. (2008) Magnetic resonance imagine in Tietze’s Syndrome. Clinical and Experimental Rheumatology, 26, 848-853. [12] Landon, J. and Malpas, J.S. (1959) Tietze’s Syndrome. Annals of Rheumatic Disease, 18, 249-254. doi:10.1136/ard.18.3.249 [13] Semble, E.L. and Wise, C.M. (1988) Chest pain: A rheumatologist’s perspective. Southern Medical Journal, 81, 64-68. doi:10.1097/00007611-198801000-00014 [14] Langford, C.A. and Mandell, B.F. (2012) Chapter 336. Arthritis associated with systemic disease, and other arthritides. In: Longo, D.L., et al., Harrison’s Principles of Internal Medicine, The MacGraw-Hill Companies, Inc., New York, 2858-2859. [15] Stochkendahl, M.J. and Christensen, H.W. (2010) Chest pain in focal musculoskeletal disorders. Medical Clinics of North America, 94, 259-273. doi:10.1016/j.mcna.2010.01.007 [16] Fioravanti, A., Tofi, C., Volterrani, L. and Marcolongo, R. (2002) Malignant Lymphoma Presenting as Tietze’s Syndrome. Arthritis and Rheumatism, 47, 229-230. doi:10.1002/art.10401 [17] Koren, W. and Shahar, A. (1998) Xiphodynia masking acute myocardial infarction: A diagnostic cul-de-sac. Journal of Emergency Medicine, 16, 177-178. [18] Mathew, A.S., El-Haddad, G., Lilien, D.L. and Takalkar, A.M. (2008) Costosternal chondrodynia simulating recurrent breast cancer unveiled by FDG PET. Clinical Nuclear Medicine, 33, 330-332. doi:10.1097/RLU.0b013e31816a7a38 [19] Cocco, R., Galieni, P., Bellan, C. and Fioravanti, A. (1999) Lymphomas presenting as Tietze’s Syndrome: A report of 4 clinical cases. Annali Italiani di Medicina Interna, 14, 118-123. [20] Jeon, I.H., Jeong, W.J., Yi, J.H., Kim, H.J. and Park, I.H. (2010) Non-Hodgkin’s lymphoma at the medial clavicular head mimicking Tietze’s Syndrome. Rheumatology International, 32, 2531-2534. doi:10.1007/s00296-010-1397-2 [21] De Filippo, M. et al. (2007) MRI findings of Tietze’s syndrome mimicking mediastinal malignancy on MDCT. European Journal of Radiology Extra, 65, 33-35. doi:10.1016/j.ejrex.2007.10.006 [22] Krohn-Gimberghe, B., Kurzeja, R., Wagner, J. and Kaiser, H.E. (1999) Pleomorphic T-cell lymphoma with chondropathia tuberose; A case report and review. Anticancer Research, 19, 2221-2228. [23] Epstein, S.E., Gerber, L.H. and Borer, J.S. (1979) Chest wall syndrome: A common cause of unexplained cardiac pain. The Journal of the American Medical Association, 26, 2793-2797. doi:10.1001/jama.1979.03290520017017
[1] Gijsbers, E. and Knaap, S.F. (2011) Clinical presentation and chiropractic treatment of Tietze Syndrome: A 34-year-old female with left-sided chest pain. Journal of Chiropractic Medicine, 10, 60-63. doi:10.1016/j.jcm.2010.10.002 [2] Hiramuro-Shoji, F., Wirth, M.A. and Rockwood Jr., C. (2003) Atraumatic conditions of the sternoclavicular joint. Journal of Shoulder and Elbow Surgery, 12, 78-88. doi:10.1067/mse.2003.128566 [3] Wolf, E. and Stern, S. (1976) Costosternal Syndrome: Its frequency and importance in differential diagnosis of coronary heart disease. Archives of Internal Medicine, 136, 189-191. doi:10.1001/archinte.1976.03630020043010 [4] Tietze, A. (1921) über eine eigenartige häufung von fällen mit dystrophie der rippenknorpel. Berliner Klinische Wochenschrift, 58, 829-831. [5] Rare Diseases and Related Terms, National Institutes of Health (2013). http://rarediseases.info.nih.gov/RareDiseaseList.aspx?PageID=1. [6] Aeschlimann, A. and Kahn, M.F. (1990) Tietze’s Syndrome: A critical review. Clinical and Experimental Rheumatology, 8, 407-412. [7] Jelenko, C. and Cowan, G. (1977) Perichondritis (Tietze’s Syndrome) at the xiphisternal joint: A mimic of severe disease. Journal of the American College of Emergency Physicians, 6, 536-542. doi:10.1016/S0361-1124(77)80424-3 [8] Epstein, S.E., Gerber, L.H. and Borer, J.S. (1979) Chest wall syndrome: A common cause of unexplained cardiac pain. The Journal of the American Medical Association, 26, 2793-2797. doi:10.1001/jama.1979.03290520017017 [9] Mukamel, M., Kornreich L., Horev, G., Zebria, A. and Mimouni, M. (1997) Tietze’s Syndrome in children and infants. Journal of Pediatrics, 131, 774-775. doi:10.1016/S0022-3476(97)70114-8 [10] Pikning, J.M., De Boeck, H. Desprechins, B. and Ernst, C. (2003) Tietze’s Syndrome in a 2-year-old boy. Nederlands Tijdschrift Geneeskunde, 43, 2134-2136. [11] Volterrani, L., et al. (2008) Magnetic resonance imagine in Tietze’s Syndrome. Clinical and Experimental Rheumatology, 26, 848-853. [12] Landon, J. and Malpas, J.S. (1959) Tietze’s Syndrome. Annals of Rheumatic Disease, 18, 249-254. doi:10.1136/ard.18.3.249 [13] Semble, E.L. and Wise, C.M. (1988) Chest pain: A rheumatologist’s perspective. Southern Medical Journal, 81, 64-68. doi:10.1097/00007611-198801000-00014 [14] Langford, C.A. and Mandell, B.F. (2012) Chapter 336. Arthritis associated with systemic disease, and other arthritides. In: Longo, D.L., et al., Harrison’s Principles of Internal Medicine, The MacGraw-Hill Companies, Inc., New York, 2858-2859. [15] Stochkendahl, M.J. and Christensen, H.W. (2010) Chest pain in focal musculoskeletal disorders. Medical Clinics of North America, 94, 259-273. doi:10.1016/j.mcna.2010.01.007 [16] Fioravanti, A., Tofi, C., Volterrani, L. and Marcolongo, R. (2002) Malignant Lymphoma Presenting as Tietze’s Syndrome. Arthritis and Rheumatism, 47, 229-230. doi:10.1002/art.10401 [17] Koren, W. and Shahar, A. (1998) Xiphodynia masking acute myocardial infarction: A diagnostic cul-de-sac. Journal of Emergency Medicine, 16, 177-178. [18] Mathew, A.S., El-Haddad, G., Lilien, D.L. and Takalkar, A.M. (2008) Costosternal chondrodynia simulating recurrent breast cancer unveiled by FDG PET. Clinical Nuclear Medicine, 33, 330-332. doi:10.1097/RLU.0b013e31816a7a38 [19] Cocco, R., Galieni, P., Bellan, C. and Fioravanti, A. (1999) Lymphomas presenting as Tietze’s Syndrome: A report of 4 clinical cases. Annali Italiani di Medicina Interna, 14, 118-123. [20] Jeon, I.H., Jeong, W.J., Yi, J.H., Kim, H.J. and Park, I.H. (2010) Non-Hodgkin’s lymphoma at the medial clavicular head mimicking Tietze’s Syndrome. Rheumatology International, 32, 2531-2534. doi:10.1007/s00296-010-1397-2 [21] De Filippo, M. et al. (2007) MRI findings of Tietze’s syndrome mimicking mediastinal malignancy on MDCT. European Journal of Radiology Extra, 65, 33-35. doi:10.1016/j.ejrex.2007.10.006 [22] Krohn-Gimberghe, B., Kurzeja, R., Wagner, J. and Kaiser, H.E. (1999) Pleomorphic T-cell lymphoma with chondropathia tuberose; A case report and review. Anticancer Research, 19, 2221-2228. [23] Epstein, S.E., Gerber, L.H. and Borer, J.S. (1979) Chest wall syndrome: A common cause of unexplained cardiac pain. The Journal of the American Medical Association, 26, 2793-2797. doi:10.1001/jama.1979.03290520017017