Tietze's syndrome, a nonsuppurative, tender swelling of the anterior chest wall, is a disorder of uncertain etiology and pathology, unassociated with constitutional disturbances, and of a prolonged fluctuating course. Familiarity with the uniform clinical manifestations of this relatively frequent entity makes its recognition fairly simple. The therapeutic approach includes reassurance of the patient as to the benign nature of this condition, along with supportive measures chiefly to allay pain.
Le syndrome de Tietze, un non-suppurative tumescentia de character hyperesthetic del pariete antero-thoracic, es un disordine de incerte etiologia e pathologia, non associate con disturbationes constitutional, e de curso fluctuante e prolongate. Familiaritate con le uniforme manifestationes clinic de iste relativemente frequente entitate rende su recognition satis simple. Le therapeutica include reassecurar le patiente con respecto a1 character benigne de iste condition e le us0 de mesuras supportative, principalmente pro alleviar le dolores.
IETZE'S SYNDROME is a benign, self-limiting entity characterized by T tender, nonsuppurative swelling in the region of the anterior chest wall.
Tietze first described the condition by reporting four cases in 1921.l The review2 of the world literature up to 1955 by Kayser disclosed 159 reported cases, of which only 7 had appeared in North American j0urnals.3,~ The total number of reported cases of Tietze's syndrome now exceeds 250, with approximately half being reported in the short span of the five-year period between 1955 and 1960. Articles dealing with this subject have yet to appear in the English or American journals devoted to rheumatology.
Since the cause and pathology of this condition remain obscure, the term Tietze's syndrome is preferred to Tietze's disease. Other names affixed to this entity include costal chondritis, costochondral syndrome, thoracochondralgia, thoracochondritis, and chondropathia tuberosa. The purpose of this report is to describe two additional cases and review the 129 cases reported in the world literature since Kayser's comprehensive review of 1956.
CASE REPORTS
Case 1 .-A 48-year-old, white, married salesman came to the medical outpatient clinic of the Jersey City Medical Center because of intermittent pain and swelling of four years' duration at the upper costosternal area. He did not recall either trauma or upper respiratory infection preceding the onset of symptoms. The pain occurred both at rest and during exertion and was not related to time of day, lasting from several minutes to hours and occasionally persisting for days. Relief could readily be obtained by the ingestion of aspirin and the local application of hot compresses. Pain and swelling were limited to thd left side, until the six months preceding his visit, at which time it was confined to the right. Occasionally the pain radiated to the right shoulder. The attacks recurred every one to four From the Department of Medicine, Setm Hall College of Medicine and Dentisty, M a l ical center, Jmseg city, N . J.