People with Tietze's disease have pain, inflammation and swelling in the costal cartilages, or the cartilage that reaches from the ribs to the breastbone. This disorder may be related to some rheumatic diseases, but physicians are not sure. Some people may need to take pain medications or anti-inflammatory medications, but there is no mention of a change in diet having any affect, per Pierre Theodore, M.D., Assistant Professor of Surgery at the University of California in "Current Diagnosis & Treatment: Surgery."
What is Tietze's Disease?
Tietze's syndrome is the inflammation and painful swelling of at least one of the costal cartilages in the chest, or the cartilage that goes from the ribs to the breastbone. People with this disorder are usually younger than 40 years old, and it affects both women and men alike, according to Carol Langford, M.D., director of the Center for Vasculitis Care and Research in "Harrison's Principles of Internal Medicine." Most people have the disorder in only one cartilage, and it is usually either the second or third one.
Cause of Tietze's Syndrome
Physicians do not yet know what causes this disorder. There is no evidence that it is the result of diet. There is evidence that it may be related to the rheumatic diseases in which there is no rheumatoid factor antibody, writes Dr. Theodore in "Current Diagnosis & Treatment: Surgery." Rheumatoid arthritis is a rheumatic disease, in which the rheumatoid factor antibody fights inflammation. In ankylosing spondylitis, a rheumatic inflammatory disease of the spine and pelvis, the rheumatoid factor antibody is absent.
Symptoms
Some sufferers may suddenly have pain in the front of their chest, while in others, the pain is gradual. The pain usually spreads from the chest to the shoulders and even to the arms. Any twisting movement of the chest, or any coughing, sneezing or breathing in deeply, will usually make the pain much worse, explains Dr. Langford in "Harrison's Principles of Internal Medicine." The pain is often mistakenly thought to be a heart problem, because the pain is in the chest and spreads.
Evaluation
A physician can usually make the evaluation through a physical examination, from seeing that the pain is worse during movement, and from taking a history of the symptoms. Dr. Theodore writes in "Current Diagnosis & Treatment: Surgery" about several medical reports in which some physicians suggest using a CT of the chest and a bone scan to help make the evaluation. A bone scan is a test that uses a small amount of a radioactive substance to see where there is inflammation in the bones.
Treatment
The pain and swelling of Tietze's syndrome usually goes away with no treatment, but it may also reoccur. Doctors often prescribe pain or anti-inflammatory medications to manage the problem. A change of diet does not affect this disorder. A physician may treat it with a local glucocorticoid injection, or with glucocorticoids taken by mouth. Glucocorticoids are synthetic steroid hormones used because they fight inflammation. In Current Diagnosis & Treatment: Surgery," Dr. Theodore explains that if people have pain and swelling for more than three weeks, a surgeon may remove the inflamed cartilage. This usually cures the disorder.
References
- "Current Diagnosis & Treatment: Surgery"; Gerard Doherty, M.D.; 2010
- "Harrison's Principles of Internal Medicine"; Anthony Fauci, M.D., Dennis Kasper, M.D., Dan Longo, M.D. et al.; 2008
