Syndrome titze (costochondritis): symptoms and treatment

Titze Syndrome

Titze Syndrome(costal-cartilaginous syndrome, rib chondritis) is a disease from the group of chondropathies, accompanied by aseptic inflammation of one or more of the superior costal cartilage in the area of ​​their articulation with sternum.

It manifests a local soreness in the place of the lesion, amplified under pressure, palpation and deep breathing. As a rule, there is no apparent cause, but in a number of cases there may be a connection with physical exertion, operations in the chest area, etc.

The disease is often found in clinical practice, but it is among the little-known. Titze's syndrome does not pose a danger to the patient's life. The forecast is favorable.

If this pathology is suspected in adults, more serious causes of pain in the chest should be excluded. The treatment is conservative.

Titze syndrome is an aseptic inflammation of one or more costal cartilage in the area of ​​their connection with the sternum. Usually suffer II-III, less often - I and IV ribs. As a rule, the process captures 1-2, rarely 3-4 edges.

In 80% of cases one-sided defeat is noted. The disease is accompanied by swelling and pain, sometimes - radiating into the arm or chest. The causes of development are not fully understood.

The treatment is conservative, the outcome is favorable.

The disease usually develops at the age of 20-40 years, although an earlier beginning is recorded - at the age of 12-14 years. According to most authors, men and women suffer equally often, but some researchers note that in adulthood, Tietze's syndrome is more common in women.

Causes and predisposing factors of the development of the Tietze syndrome

Although the causes of the Tietz syndrome are not fully understood at the moment, there are several theories explaining the mechanism of the development of this disease. Traumatic theory.

Many patients suffering from Tietz syndrome are athletes, are engaged in heavy physical labor, suffer acute or chronic diseases accompanied by severe coughing, or have an injury to the ribs in anamnesis.

Supporters of this theory believe that because of direct trauma, permanent microtrauma or overload of the shoulder belt, cartilage is damaged, micro-fractures appear on the border of the bone and cartilage part.

Currently, traumatic theory is most recognized in the scientific world and has the most evidence.

Infectious-allergic theory.

The followers of this theory find a connection between the development of the Tietze syndrome and the acute respiratory diseases that occurred shortly before, which provoked a decrease in immunity.

In favor of this theory may also indicate a more frequent development of the disease in people with drug addiction, as well as in patients who have recently undergone surgery on the thoracic cell.

Alimentary-dystrophic theory. It is assumed that degenerative disorders of cartilage arise due to a violation of calcium metabolism, vitamins of group C and B.

This hypothesis was expressed by Tietze himself, who first described this syndrome in 1921, but now the theory belongs to the category of doubtful, because it is not supported by objective data.

Patients complain of acute or gradually increasing pains that are located in the upper parts of the chest, next to the breastbone.

The pains are usually one-sided, intensified with deep breathing, coughing, sneezing and movement, can be given to the shoulder, arm or chest on the side of the lesion.

When examined, pronounced local tenderness is observed during palpation and pressure. A dense, clear swelling of the spindle-shaped 3-4 cm in size is revealed.

Diagnosis and differential diagnostics of the Tietze syndrome

Diagnosis of Tietze syndrome is mainly based on clinical data, after exclusion of other diseases that could cause chest pain. And one of the main symptoms confirming the diagnosis is the presence of a characteristic clear and dense swelling, which is not detected any more in any disease.

In the course of differential diagnosis exclude acute trauma, diseases of the cardiovascular system and internal organs that could cause a similar symptomatology, including - various infectious diseases and already mentioned malignant neoplasms. If necessary, the patient is referred for blood tests, MRI, CT, ultrasound and other studies.

When X-ray study in dynamics, it is possible to detect non-sharp changes in the structure of the cartilage. At the initial stages, pathology is not determined.

After a while, thickening and premature calcification of the cartilage, appearance of bone and calcareous lumps along its edges becomes noticeable.

A few weeks later, at the anterior ends of the bone part of the affected ribs, small periosteal deposits appear, causing the rib to thicken slightly, and the intercostal space to narrow.

At later stages, the fusion of the cartilaginous and bone segments of the ribs is found, deforming the osteoarthrosis of the rib-chest joints and bone growths.

Radiography in Titze syndrome does not have independent significance at the time of diagnosis, since the first changes in the radiographs become noticeable only after 2-3 months from the beginning disease. However, this study plays an important role in the exclusion of all possible malignant tumors, both primary and metastatic.

Also, in the course of differential diagnostics with malignant neoplasms, Tc scan can be performed and Ga and puncture biopsy, in which degenerative changes in the cartilage are determined and the absence of elements tumor.

Particular alertness due to its widespread prevalence in adult patients is caused by possible cardiovascular diseases and, in the first place, ischemic heart disease.

IHD is characterized by short-term pain (on average, angina attacks last 10-15 minutes), while with Tietz syndrome, pain can persist for hours, days and even weeks.

In contrast to the Tietze syndrome, with ischemic disease, pain syndrome is stopped by drugs from the group of nitroglycerin.

For the final elimination of cardiovascular pathology, a number of analyzes and instrumental studies (ECG, etc.) are performed.

Titze syndrome also has to be differentiated from rheumatic diseases (fibrositis, spondyloarthritis, rheumatoid arthritis) and local cartilage and sternal lesions (bone chondritis and xifoidalgia).

To exclude rheumatic diseases, a number of special analyzes are performed.

The lack of hypertrophy of the costal cartilage, osiphoidalgia, which is strengthened by pressing the pain in the area of ​​the xiphoid process of the sternum, testifies to the bone-chondrite.

Changes in the biochemical composition of blood, general blood and urine tests for Titze syndrome are absent. Immune reactions are normal.

Treatment is carried out by orthopedists or traumatologists. Patients are on an outpatient observation, hospitalization, as a rule, is not required.

Patients are assigned topical treatment with ointments and gels containing non-steroidal anti-inflammatory drugs. Compresses with dimexide are also used.

With severe pain syndrome prescribe NSAIDs and painkillers for oral administration.

With persistent pain in combination with signs of inflammation that can not be suppressed by taking analgesics and nonsteroidal anti-inflammatory drugs, a good effect provides the introduction of novocaine with hydrocortisone and hyaluronidase in the affected region. In addition, physiotherapy, reflexology and manual effects are used.

Very rarely, with the persistent course of the disease and the ineffectiveness of conservative therapy, surgical treatment is required, which consists of subperiosteal resection of the rib. Surgical intervention is performed under general or local anesthesia in a hospital setting.

A source: http://www.krasotaimedicina.ru/diseases/traumatology/tietze-syndrome

Titze Syndrome (rib chondrite): symptoms and treatment (in tch folk) and pr + photo

The rib chondrite is called the person who first described it, and later the pathology was called the Titze syndrome. This is a process, which is based on the inflammation of the joint area of ​​the ribs and sternum.

It manifests itself in pain in the chest, which becomes stronger during palpation. Often the pain passes independently and does not give serious consequences.

The reasons are still a mystery for doctors.

What is the essence?

Why there is aseptic inflammation in the place where the ribs are attached to the sternum is not known for certain. In medical books, the name has many interpretations. The most common in both sexes is between the ages of 20 and 40, and in adolescents from 12 to 14 years.

The junction of the ribs and sternum

To answer unequivocally, why so everything happens, doctors can not and to this day. But if we follow the development of the disease, that is, the trigger factors that give rise to the development of the process, then they can become:

• Systematic severe or moderate stress on the shoulder or chest area.
• Microtrauma, which accompany injuries and bruises of the chest. Often in this category there are athletes who are engaged in martial arts.
• Infectious diseases with severe course.
• Allergic reactions.
• Pathology of the respiratory tract.
• Defects of metabolism occurring in connective tissue. There are several pathologies that lead to this: arthrosis, collagenosis, arthritis, collagenosis.

Another possible cause of the Tietz syndrome can be called a decrease in the immune properties of the body.

Also, the development of the disease occurs after surgical interventions on the thoracic region, due to which the circulatory disturbance develops.

Often, the pathology develops after infection in the postoperative wound.

Symptomatology

With the disease, the cartilage is reconstructed, its curvature, increase in volume and accumulation of calcium salts in this area occur. Symptomatology, as a rule, is not pronounced, the main symptom is pain.

The localization of pain occurs in the upper part of the chest, most often on the one hand.All is amplified during movement or coughing, provokes them also deep breathing.

You can give pain to the upper limb, neck or shoulder from the appropriate side.

Titze syndrome on X-ray

Pain is intensified after hypothermia or when the affected rib is touched at the point of attachment to the sternum.

Attention attracts attention dense and with clear contours swelling.

Accompany the swelling may be a small swelling and redness, above the affected area, skin temperature may increase.

The pain that accompanies the Tietze syndrome can be short-lived, but it can also be troubling for a long time.

Also, the pain is characterized by chronicity with periods of exacerbations and remission.

Diagnosis in the presence of swelling in the rib cartilage

To put out the correct diagnosis can be extremely difficult and for this it is necessary to conduct differential diagnosis and exclude diseases that have a similar clinical picture.

The main feature that allows to expose the Tietze syndrome is the presence of swelling in the rib cartilage, which is not present on any joint of the cartilage with the sternum.

In addition, CT, MRI or ultrasound can be performed, and if necessary, the doctor can take a biopsy of the affected area, followed by examination of the cartilage cells.

Treatment

To fight with Tietz syndrome it is possible and in the conditions of a polyclinic at the doctor of the surgeon or the traumatologist. Prescribed compresses based on Dimexide or ointments and gels, which contain non-steroidal anti-inflammatory drugs.

If a person is worried about severe pain, then it is possible to take tablet forms of analgesics prescribed by a doctor.

The use of Novocain blockade of the intercostal nerves area is also indicated. You can additionally use corticosteroids with the addition of anesthetics.

The methods of physiotherapy, such as reflexotherapy, which help to remove the inflammatory process and pain, are successfully applied.

In the case of an unsuccessful result with conservative treatment, although it can be very rarely seen, it is shown surgical intervention: subperiosteal resection of the rib with removal of the altered area of ​​the cartilaginous tissue.

Application of folk methods

Traditional medicine can also be used for costal perichondritis and its essence is aimed at increasing the immune system and improving blood circulation in the affected area. With these purposes, compresses, rubbers or broths are used.

The broth is prepared from medicinal herbs: thyme, sage and juniper fruits, as well as St. John's Wort.

Compress is superimposed on the affected area and covered with a warm shawl or woolen cloth on top.

Help compresses, which include a decoction of rosemary, the effect is and steamed leaves horseradish or lemon balm.

Grind the chest in the place of defeat can be bearish, and in its absence, lard fat. You can use alcohol based infusions based on birch buds or eucalyptus. After the place of grinding is covered with a warm blanket, so the warming effect will last much longer.

Photo gallery of components of folk remedies

ChabretzJuniper's fruitJuniper's skeletonsSalphiaThreeboyMelissa

With timely treatment, the prognosis for Titze syndrome is favorable and there is no trace after the disease.

The main thing is, if you have a primary symptomatology, go to a specialist and follow all his recommendations. And, if necessary, be fully examined in order to establish the true cause.

It is better not to admit disease at all, avoiding provoking factors.

A source: http://spina-sustav.ru/bolezni/sindrom-tittse-chto-eto.html

Tietze's disease

Pain in the chest area is a very common complaint among people of any age, including among children.

Many patients immediately consider such symptoms manifestations of heart disease, but this is far from the case.

There are a lot of pathological processes that are accompanied by pain in the chest, among them there is a disease like the Tietze syndrome.

What it is

Titze syndrome (or costal chondritis) is an inflammatory lesion of one or more costal cartilage. This pathology was first described in 1921 by the German doctor A. Tietze.

All the front ends of the ribs end in costal cartilages, through which they connect to the breastbone and each other.

The main function of these cartilaginous formations is the attachment of the ribs to the sternum and the elasticity of the walls of the chest.

The first 7 pairs of cartilages are attached directly to the sternum, the next 3 pairs are articulated with the cartilage of the rib located higher, and the last two pairs terminate blindly in the wall of the abdominal cavity.

Schematic structure of the chest

According to the International Classification of Diseases of the 10th revision (ICD-10), the costal chondritis has the code M94.0 (the syndrome of cartilage rib joints - Titze).

The disease is rare, usually affects older children and adolescents, as well as adults under 40 years. Men and women suffer equally often.

Causes and risk factors

To determine the true causes of the development of the Tietze syndrome to date, it was not possible.

Alexander Tietze believed that the inflammation of the costal cartilage develops due to irrational nutrition and, as consequence, because of the violation of metabolic processes in the body, which lead to dystrophic changes cartilage tissue.

At the moment, experts have developed 3 theories of the possible origin of the disease:

Traumatic theory

It is that the constant microtraction of cartilage tissue of rib cartilage in people of a certain occupation (athletes, workers physical labor) or suffered serious chest damage, surgery on the thoracic cavity provokes an abnormal process of regeneration perichondrium. Cartilage cells, which are formed, differ from normal cells, in addition, they are formed in excess.

This is accompanied by the development of aseptic inflammation, as well as squeezing or irritation of a number of lying nerve fibers, which causes the development of symptoms of Tietz syndrome and pain.

This theory has received many clinical confirmations so far, so it takes the leading place in the etiology of this disease.

Athletes are at risk of developing Tietze syndrome due to frequent trauma

Infectious-allergic theory

In this case, the development of rib chondritis is associated with the transmitted infections, especially the respiratory organs.

As a result of such infections, the normal functioning of the body's immune system is disrupted, which leads to the formation of a kind of allergic process.

In this case, the antibodies that are formed have the ability to affect the cartilaginous tissue of the ribs.

Alimentary-dystrophic theory

According to this theory, dystrophic disorders in the cartilaginous tissue develop due to the dysmetabolic processes promoted by the violation of rational nutrition.

In particular, Tietze's syndrome can be one of the manifestations of deficiency in the body of calcium, vitamins B, C, D.

At the moment, this theory is almost not considered by specialists as the etiology of costochondritis.

Deficiency of vitamins and microelements can provoke the development of the Tietze syndrome

The main risk factors for Tietz syndrome include:

• daily physical activities that involve the shoulder belt and chest;
• frequent injuries and microtrauma of the structures of the chest;
• bruises and fractures of the skeleton of the thorax;
• ailments of the respiratory organs, especially of a chronic nature;
• transferred infectious diseases;
• autoimmune processes and systemic diseases of connective tissue;
• arthritis and arthritis in the anamnesis;
• propensity to allergic reactions;
• disturbance of metabolic processes in the body;
• endocrinological pathology.

How does the disease develop?

In most cases, the Titze syndrome has a one-sided character and is more common on the left side of the chest. In 60% of cases the cartilaginous zone of 2 ribs is inflamed, in 30% of cases - cartilage of 2-4 ribs, and in 10% suffers costal cartilage of 1, 5, 6 ribs.

The disease is characterized by a prolonged course with periods of exacerbations and remissions. A few months after the onset of inflammation in the cartilaginous tissue, degenerative-dystrophic changes begin.

The damaged area appears bone density, which contributes to the development of apparent deformation of the chest, a decrease in its motor efficiency and elasticity.

Funnel-shaped deformation of the chest may be a consequence of the Tietze syndrome

Symptoms of costochondritis

Unfortunately, Tietze's syndrome does not have pronounced clinical signs, so it is often problematic to detect this disorder. As already mentioned, the pathology is characterized by a prolonged course with periods of exacerbations and remissions.

The main symptoms of debut or exacerbation of the Tietze syndrome:

• pain in the anterior thoracic region, which are often acute, but the aching character of the pain syndrome is also possible;
• increased pain during movement and deep breathing;
• also the pain is intensified by pressing the affected cartilage of the rib;
• swelling or swelling in the area of ​​inflammation;
• the appearance of crepitations when moving in the area of ​​damaged cartilaginous tissue.

Pain in the sternum - the main sign of costal chondritis

Some patients have additional symptoms:

• anxiety, irritability, fear;
• cardiopalmus;
• sleep disturbance;
• development of dyspnea;
• lack of appetite;
• temperature increase;
• redness in the area of ​​damage to the costal cartilage.

As a rule, the aggravation lasts from several hours to several days. If the disease progresses, the patient becomes difficult to lie on his side, to exercise any movements of the upper limbs and trunk. Also, the pain increases with coughing, sneezing, laughing.

Symptoms of the Tietze syndrome subsided on their own. But if the pain is intense and interferes with the daily activities of a person, then treatment is needed.

By the way, the use of non-steroidal anti-inflammatory drugs is a kind of diagnostic test.

In the case of a decrease or disappearance of pain after taking the NSAID tablets, it is highly likely that the Tietze syndrome should be suspected.

Complications and consequences

Complications of the Tietze syndrome are extremely rare. But sometimes the syndrome of excessive calcification of the cartilaginous tissue develops. This is accompanied by ossification of the costal cartilage, their deformation and loss of basic functions. At the same time, pain can become worse and become chronic.

In such cases, the breathing process may be disturbed and respiratory failure may develop due to the rigidity of the chest. Another possible consequence is the deformation of the chest.

Diagnostic Methods

Diagnosis of Tietz syndrome is difficult and is based on clinical symptoms and patient history. No specific laboratory signs exist.

There are no changes in general and biochemical analyzes of urine and blood.

If the disease developed for the first time, there may be non-specific signs of inflammation - an increase in ESR, the appearance of a C-reactive protein, a shift of the leukocyte formula to the left.

X-ray can be used as an additional diagnostic method. In this case, you can see a thickening of costal cartilage in the form of a spindle in the anterior part of the costal bones.

Chest X-ray allows diagnosis of Tietze syndrome

This method of research allows you to visualize in detail all the pathological changes that occurred in the tissues of the costal cartilage.

Also for the purpose of diagnosis, CT and ultrasound can be used.

Recommended revered: rib break marks

Differential diagnosis of Tietze syndrome with such diseases is carried out:

• rheumatic fever;
• trauma of the chest;
• breast diseases in women;
• diseases of the cardiovascular system - angina pectoris, myocardial infarction, cardialgia;
• intercostal neuralgia;
• myositis;
• tumor formations of this region;
• ankylosing spondylitis.

In case of developing symptoms that resemble the Tietze syndrome, you need to turn to such specialists as a neurologist, traumatologist-orthopedist, family doctor.

Treatment of the Tietze syndrome

As a rule, Titze's syndrome does not require any treatment and completely passes on its own after a few hours-a-day. But in cases where the pain syndrome is expressed and there are other symptoms of pathology, specific therapy may be needed.

Conservative treatment

An irreplaceable standard of conservative therapy of costal chondritis is the use of nonsteroidal anti-inflammatory drugs - Diclofenac, Piroxicam, Indomethacin, Meloxicam, celecoxib, etorikoksib, Ketoprofen, Nimesulide.

These drugs can be used in the form of tablets, injectable solutions, ointments, gels, patches for topical application.

Also, experts recommend to supplement the treatment with warming drugs for topical application - Capsicum, Finalgon, Fastum-gel, etc.

The course of therapy is usually from 3 to 7 days. At this time, the patient must comply with the regime - complete physical rest, avoidance of hypothermia.

A good addition to drug therapy is physiotherapy. Most often, such patients have a positive effect when used:

• laser treatment,
• electrophoresis,
• phototherapy,
• darsonvalization.

If the pain syndrome can not be suppressed by the described methods, then resort to intercostal blockades with the use of local anesthetics, glucocorticosteroid hormones.

Intercostal blockade allows to eliminate even very intense pain in the Tietze syndrome

Surgical intervention

Operative intervention is an extreme measure of treatment for patients with Tietze syndrome. Apply the surgery only in case of inefficiency of all other therapies. The essence of the operation lies in the subperiosteal resection of damaged costal cartilage.

Prophylaxis and prognosis

To prevent further exacerbations of the costal chondritis, one can follow such simple recommendations:

• avoid hypothermia;
• minimize excessive physical exertion;
• protect yourself from injury;
• regular sanatorium treatment, especially useful mud resorts;
• rational and healthy nutrition;
• timely treatment of respiratory tract infections.

The prognosis of the disease is favorable. To avoid possible complications, you just need to just go to the doctor who will prescribe the appropriate treatment.

A source: http://MoyaSpina.ru/bolezni/bolezn-titce

Symptoms of Tietze syndrome, or costal chondritis

Titze syndrome is associated with an inflammatory process of the cartilage or a group of cartilages located in the chest.

Pathology has several names, among which there are such as rib chondritis.

Symptoms of the disease are based on the appearance of soreness in the area of ​​inflammation, while the pain intensifies pressure, palpation and deep breathing, coughing, sneezing, that is, factors that cause increased movement of the thoracic cells. The place of damage in medicine is called the rib-sternal articulation. The Tietz syndrome appears for a number of reasons, but the exact relationship between the onset of the disease is being studied up to the present.

Causes of pathology

In practice, costal chondritis occurs infrequently, which is why it is difficult to establish exact causes.

In some cases, the disease occurs against the background of a healthy organism, and sometimes appears as a complication of the ongoing disease affecting the cartilaginous tissue.

There are two stages - light and heavy, requiring a long recovery.

The causes of the Tietze syndrome are divided into subgroups. The main causes of chondrite lie in injuries and overloads of the musculoskeletal system.

In most cases, athletes suffer because their history of life combines constant muscle loads and trauma.

Suffer people of physical labor, giving loads on the muscles of the shoulder girdle and chest.

The causes of the Tietze syndrome are associated with chronic diseases, the symptoms of which put stress on the muscles of the chest.

To this category of people carry chronicles with bronchitis, bronchial asthma, frequent ARI and SARS.

When the traumatic effect affects the cartilaginous tissue in the border area of ​​the bone and cartilage, causing microcracks and micro-fractures.

In place of microtraumas, an unnatural tissue builds up, which exerts pressure on the nerve endings and vessels, leading to the appearance of symptoms of the Tietze syndrome.

Ribbed chondrite can occur against the background of ongoing diseases of infectious and allergic genesis. With these diseases, immunity decreases, the body does not resist inflammation.

Minimal injury or excessive cough leads to destruction of the tissue of the cartilage of the ribs. Often, the causes of Tietze's syndrome are combined.

Thus, an operation in the thoracic region injures tissues, which eventually cicatrize, but if there is infection and there are symptoms of coughing, sneezing, there is inflammation in the area of ​​the surgical interference.

Allocate such infections, which destroy the tissues of the body. They include the impact of tuberculosis, syphilis. If such a disease occurs, the chondrite threat increases.

The Tietze syndrome can be triggered by degenerative-dystrophic processes in the cartilaginous tissue. They cause their broken metabolism, lack of vitamins and minerals. Pathology with such factors develops rarely. Arthritis is one of the causes of the disease.

Symptoms - chondritis

Symptoms of Tietze syndrome are associated with the vastness of the inflammation. The rib chondrite can affect both one and several cartilage ribs.

Place inflammation is limited in the sternum zone. According to statistics, 2-3 ribs are involved in the process, the 1st and 4th ribs suffer less often.

There are forms of chondritis, when all four ribs in the sternum region become inflamed.

Symptoms of the disease occur in people aged 20 to 40 years, moreover, women suffer more often. The case of inflammation in adolescents was recorded.

In most cases, the process of inflammation occurs on the one hand, therefore, the symptoms are one-sided.

Symptoms of soreness are acute with gradual increase. The pain syndrome increases during a deep breath, coughing, sneezing. With pressure or load, soreness delivers into the shoulder and arm area.

The Tietze syndrome is prone to chronic course, so the symptoms may appear briefly and disappear.

With the progression of the process, persistent pain predominates, lasting for several days, followed by periods of remission.

Externally, there may be hyperemia in the area of ​​inflammation, puffiness. When palpation there is an increase in soreness and palpation is felt at the junction of the rib with the sternum.

Diagnosis - X-ray

Titze's syndrome is not always evident from the first time. Even the appointment of an X-ray does not always reveal the process of inflammation.

The chondrite progresses slowly, therefore in the initial stages the changes in cartilage tissue are insignificant.

If an x-ray is performed after a short period of time, then it is difficult to detect degenerative changes.

Hondrite combines a complex of symptoms, resulting in a diagnosis in combination with instrumental research.

It is important to conduct differential diagnosis with diseases of the heart, blood vessels, spine. Exclude infectious processes, inflammation in the respiratory system, including tuberculosis.

For the diagnosis of Tietze syndrome, the following methods are used:

• ultrasound diagnostics;
• Magnetic resonance imaging;
• CT scan;
• X-ray.

To study the general condition of the body, blood, urine, rheumatology test, blood sugar are assigned.

With the help of an X-ray, it is possible to detect changes in the cartilage tissues several months after the onset of the Tietze syndrome.

X-rays are needed to exclude other diseases, including oncology and tuberculosis.

With the help of CT diagnostics it is possible to diagnose in the early stages. Symptoms of the disease are similar to rheumatism and arthritis, therefore it is necessary to exclude these pathologies.

Treatment for a syndrome

Treatment for the syndrome is conservative, aimed at reducing symptoms of pain, discomfort and stopping the progression process. The operation is performed only in the presence of accompanying pathologies that threaten the life and health of the patient.

Treatment for Tietze syndrome is performed by a trauma doctor if there are trauma factors or an orthopedist. Consultation of a neurologist is necessary for severe pain, in order to exclude damage to the nerves.

Conservative treatment is divided into external agents (ointments, compresses, exercise therapy, physiotherapy) and internal medications.

Their medicines are prescribed drugs of the NSAID group. The choice is based on Diclofenac, Movalis, Ibuprofen and Nimesulide.
Preparations of NSAIDs relieve sensations of pain, swelling and inflammation.

To eliminate inflammation apply Traumeel, Novokain.

Hormonal drugs are necessary for Tietze syndrome with severe pain, limited movement and progression of pathology.

The choice is between the course of prednisolone and hydrocortisone. The doctor monitors the dosage, the duration of hormone therapy and gradually reduces the dose of the drug.

Sharply to cancel hormones it is impossible.

It is effective to use topical ointments, in which the preparations of the NSAID group, Dimexide, analgesics. Vitamins of group B favorably influence on immunity, system of innervation. The complex uses a course of physiotherapy and gymnastics for muscle recovery.

The started stages require the assignment of the operation. In the course of the operation, the rib is resected. During the recovery period, physiotherapy, exercise therapy and a course of NSAIDs are needed to relieve soreness.

Specific prophylaxis of chondrite is not developed, as the disease is rare.

When there are symptoms of chest pain, it is recommended to perform an X-ray examination to exclude dangerous pathologies.

If the X-ray does not show changes, and the symptoms do not go away, you need to consult with a narrow specialist and complete a complete examination.

For the prevention of sports and physical labor, you must adhere to safety rules to avoid injury. Sports activities strengthen the muscular corset, which in the future will resist injuries.

A source: http://drpozvonkov.ru/pozvonochnik/drugie-bolezni/sindrom-tittse.html

Tietze syndrome - connective tissue disease

Titze syndrome is a connective tissue disease classified as chondropathy and manifested by aseptic inflammation, thickening and soreness of the cartilages of the upper ribs at the point of attachment to the sternum.

In the medical literature, this disease is also called rib chondritis, perichondritis, costal cartilage syndrome, pseudocellular rib cartilage, etc.

Syndrome with the same frequency is fixed in women and men aged 20-40 years, as well as in adolescents 12-14 years.

The Tietze syndrome, named after the German surgeon first described it in 1921, is most often It is one-sided and forms 1-2 ribs in the zone of costochronous articulation, rarely in the 3-4 ribs.

Causes of the Tietze syndrome

The exact causes of the appearance of the pathology of the cartilaginous rib patches have not been fully elucidated to date. But in the patient's anamnesis, negative factors that trigger the development of the disease are always revealed. So, Tietze's syndrome can be caused:

• Systematic heavy and moderate physical exertion on the shoulder girdle and chest;
• Microtrauma, which appear due to regular injuries and bruises of the chest (in athletes engaged in martial arts);
• Severe infectious diseases;
• Allergic lesions;
• Diseases of the respiratory tract;
• Defects of metabolism in connective tissue (with arthrosis, arthritis, collagenosis, etc.).

Also, the causes of the Tietze syndrome may be a decrease in the immunological properties of the body in autoimmune diseases and surgical intervention in the thoracic region, which causes circulatory disorders and infection tissues.

Symptoms of the Tietze Syndrome

When the disease is formed, there is fibro-cystic cartilage restructuring, its curvature with insignificant hyperplasia (increase in volume), and the accumulation of calcium salts in it. Symptoms of Tietze syndrome usually are not pronounced, the main ones are:

• The pain localized in the upper part of the chest, as a rule, is one-sided and growing during movement, coughing, deep breathing, can also irradiate in the arm, neck or shoulder;
• Pain syndrome, amplified by hypothermia and when pressed on a diseased rib at the point of its attachment to the sternum;
• The presence of a dense and clear swelling, measuring 3-4 cm, located in the area of ​​inflamed rib cartilage, and causing severe pain in palpation.

Also, the symptom of Tietz syndrome can sometimes be a slight swelling, redness, and a local increase in temperature in the area of ​​the skin above the affected area.

The pain syndrome that accompanies the disease is short-term or long-term, chronic, and the exacerbations can alternate with periods of remission.

Diagnosis of the disease

The diagnosis of costal chondritis is made on the basis of clinical signs and differential diagnosis, which makes it possible to exclude other diseases having the same manifestations.

The main symptom that confirms Tietze's syndrome is the formation of a small dense swelling in the area of ​​the diseased costal cartilage, not observed with any other lesion of bone-chondral articulations.

X-ray images in the initial stage of the disease do not allow to reveal pathological changes, but help to exclude the presence of malignant neoplasms.

Treatment of the Tietze syndrome

Treatment of the disease is usually performed on an outpatient basis, the patient is prescribed therapy with using compresses with Dimexide, ointments and gels, which include non-steroid anti-inflammatory drugs. At the expressed painful syndrome and inflammatory displays for treatment of costal chondritis are prescribed analgesics for reception Inside, a novocaine blockade of the intercostal nerves or injections of corticosteroids with anesthetic. Successfully used physiotherapeutic methods of treatment and reflexotherapy, which allow to reduce pain and relieve inflammation.

If conservative treatment of Tietze's syndrome does not give positive results, and this happens usually in rare cases, resort to surgical intervention, performing subperiosteal resection ribs.

Titze syndrome: treatment with folk remedies

Treatment of the Tietze syndrome with the help of traditional medicine is aimed at increasing the body's immune defenses and improving the function of the circulatory system. For this purpose, compresses, rubbing and decoctions are used.

For the preparation of the latter, thyme, sage, juniper fruits, St. John's wort are usually used. Compresses for costal chondritis are imposed on the painful area and necessarily tie a warm shawl or woolen cloth on top.

Make compresses based on rosemary broth, and using steamed horseradish or melissa leaves.

Among the methods used to treat Tietze syndrome with folk remedies, preference is often given to paprika cells in the affected area with pork or bear fat, as well as rubbing alcohol tinctures of birch buds and eucalyptus.

After the procedure, to enhance the healing effect, you need to cover yourself with a warm blanket to extend the warming action. Before applying any methods of traditional medicine for the treatment of the syndrome, it is recommended to consult with the attending physician.

In general, with adequate treatment, the Tietze syndrome forecast is quite favorable.

A source: http://zdorovi.net/bolezni/sindrom-titce.html