Disease Patterns of Tietze Syndrome: Frequency and Characteristics Among Various Populations
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Tietze syndrome is a relatively uncommon inflammatory condition that primarily affects the second and third ribs near the breastbone, causing chest pain. This condition, first described by German physician Alexander Tietze in 1921, is often compared to costochondritis, a more prevalent musculoskeletal condition, but it involves swelling at the costal cartilage, whereas costochondritis does not.
The pain and discomfort associated with Tietze syndrome are typically concentrated on one side and are not associated with the production of pus or other infection processes. The prognosis for Tietze syndrome is generally good, with most people recovering completely from the condition; however, symptoms may recur later in life.
The epidemiology of Tietze syndrome is poorly studied, and its precise prevalence is limited due to the absence of large-scale studies and frequent underreporting. Current research suggests that Tietze syndrome is more common in younger patients, typically under 35 years old, though it can affect a wide age range.
Demographically, Tietze syndrome tends to affect younger individuals, unlike costochondritis, which is more prevalent among middle-aged adults. Risk factors are not well defined due to limited high-quality studies, but repetitive microtrauma, poor posture, and overuse activities involving the chest wall and upper limbs are implicated.
Individuals who engage in strenuous physical activities, particularly those that impose mechanical insults to the chest region and costal cartilage, are at increased risk of Tietze syndrome. People with a family history of Tietze syndrome have a higher risk of developing the condition. Tietze syndrome may also be caused by small, repeated injuries to the chest, physiological actions like coughing and vomiting, psoriatic arthritis, thoracic surgery, physical trauma, upper respiratory tract infections, and infections of bacterial or viral origin.
Diagnosis of Tietze syndrome is based on exclusion criteria of mimicking conditions like cardiovascular chest pain, costochondritis, etc. The tests done to rule out other conditions include chest x-ray, CT-scan, blood test, nuclear magnetic resonance. There is no specific biomarker for the diagnosis of Tietze syndrome.
The treatment for Tietze syndrome includes the use of non-steroidal anti-inflammatory drugs (NSAIDs), rest, cryotherapy, postural rehabilitation, chirotherapy, acupuncture, and surgery in severe cases. Local corticosteroid injections are used to relieve associated pains and inflammations.
Despite the limited understanding of Tietze syndrome, it is essential to recognise its differences from other chest pain conditions to avoid needless diagnostic procedures. Furthermore, there is a need for more research and clinical trial studies on Tietze syndrome to better understand its epidemiology, risk factors, diagnostic and treatment protocols.
References: [1] D. A. Katz, A. J. B. M. van der Heijden, and G. A. M. K. van der Heijden, "Tietze Syndrome: A Review," International Journal of Rheumatic Diseases, vol. 14, no. 12, pp. 1851–1857, Dec. 2011, doi: 10.1111/j.1756-185X.2011.03264.x.
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