Tietze Syndrome

National Organization for Rare Disorders, Inc.

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It is possible that the main title of the report Tietze Syndrome is not the name you expected. Please check the synonyms listing to find the alternate name(s) and disorder subdivision(s) covered by this report.


  • Chondropathia Tuberosa
  • Costochondral Junction Syndrome

Disorder Subdivisions

  • None

General Discussion

Tietze syndrome is a rare, inflammatory disorder characterized by chest pain and swelling of the cartilage of one or more of the upper ribs (costochondral junction). Onset of pain may be gradual or sudden and may spread to affect the arms and/or shoulders. Tietze syndrome is considered a benign syndrome and, in some cases, may resolve itself without treatment. The exact cause of Tietze syndrome is not known.


Tietze syndrome is characterized by mild to severe localized pain and tenderness in one or more of the upper four ribs. The second or third ribs are most often affected. A firm, spindle-shaped swelling occurs in the cartilage of these ribs. An aching, gripping, sharp, dull, or neuralgic pain occurs in this area. In some cases, the pain may spread to affect the neck, arms and shoulders.

The pain associated with Tietze syndrome may worsen due to sneezing, coughing, or strenuous activity or exercise. The pain usually subsides after several weeks or months, but the swelling may persist.

Costosternal chondrodynia is a rare variant of Tietze syndrome that is characterized by severe breast pain in individuals who have had reconstructive breast surgery. The pain, which occurs several months following surgery, affects the breastbone (sternum) and ribs (costosternal area).


The exact cause of Tietze syndrome is not known (idiopathic). Some researchers have speculated that multiple microtrauma to the anterior chest wall may cause the development of Tietze syndrome.

Some cases of Tietze syndrome may occur secondary to other disorders such as psoriatic arthritis.

Affected Populations

Tietze syndrome usually affects older children and young adults. Most cases occur before the age of 40. Males and females are affected in equal numbers.

Standard Therapies


A diagnosis of Tietze syndrome is made based upon a thorough clinical evaluation, a detailed patient history, identification of characteristic symptoms, and exclusion of other causes of chest pain. A variety of tests including electrocardiogram, x-rays, and biopsies may be performed to rule out more serious causes of chest pain including cardiovascular disorders or malignant conditions.


In some cases, pain associated with Tietze syndrome resolves itself without treatment. Specific treatment for individuals with Tietze syndrome consists of rest, avoidance of strenuous activity, local heat, and pain medications such as steroids or a mild pain reliever (analgesic). Usually the pain subsides after several weeks or months, but the palpable swellings may persist for some time.

Investigational Therapies

Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. government funding, and some supported by private industry, are posted on this government web site.

For information about clinical trials being conducted at the NIH Clinical Center in Bethesda, MD, contact the NIH Patient Recruitment Office:

Tollfree: (800) 411-1222

TTY: (866) 411-1010

Email: prpl@cc.nih.gov

For information about clinical trials sponsored by private sources, contact:




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Magalini SI, et al., eds. Dictionary of Medical Syndromes. 4th ed.New York, NY: Lippincott-Raven Publishers; 1997:791.

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Thongngarm T, et al. Malignant tumor with chest wall pain mimicking Tierze's syndrome. Clin Rheumatol. 2001;20:276-78.

Van Schalkwyk AJ, et al. A variant of Tierze's syndrome occurring after reconstructive breast surgery. Aesthetic Plast Surg. 1998;22:430-32.

Mukamel M, et al. Tierze's syndrome in children and infants. J Pediatr. 1999;131:774-75.

Kamel M, Kotob H. Ultrsonographic assessment of local steroid injection in Tierze's syndrome. Br J Rheumatol. 1997;36:547-50.

Pappalardo A, et al. Reflexions on the Tietze syndrome: Clinical contribution. Clin Ter. 1995;146:675-82.

Yang W, eta l. Pinhole skeletal scintigraphic manifestations of Tierze's syndrome. Eur J Nucl Med. 1994;21:947-52.

Martino G, et al. Tierze's syndrome in the elderly: description of a case and review of the literature. G Chir. 1994:15:119-23.

Aeschlimann A, Kahn MF. Tierze's syndrome: a critical review. Clin Exp Rheumatol. 1990;8:407-12.

Pye JK, et al. Clinical experience of drug treatments for mastalgia. Lancet. 1985;2:373-77.

Fam AG, et al. Musculoskeletal chest wall pain. Canadian Med Assoc Journal. 1985;133:379-89.


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For a Complete Report

This is an abstract of a report from the National Organization for Rare Disorders, Inc.® (NORD). Cigna members can access the complete report by logging into myCigna.com. For non-Cigna members, a copy of the complete report can be obtained for a small fee by visiting the NORD website. The complete report contains additional information including symptoms, causes, affected population, related disorders, standard and investigational treatments (if available), and references from medical literature. For a full-text version of this topic, see http://www.rarediseases.org/search/rdblist.html.