Tietzes: Difference between revisions

No edit summary
No edit summary
Line 10: Line 10:
== Definition/Description  ==
== Definition/Description  ==


[[Costochondritis|Costochondritis]] is a painfull chronical inflammation of the cartilago of one or more costae at <br>the transition between sternum and costae.<ref name="Fam and Smythe">Fam A.G., Smythe H.A.,Musculoskeletal chest wall pain, Can Med Assoc J. Sept 19851; 133(5):379-389.</ref><ref name="Thongnarm et al">Thongngarm T., Lemos L.B., Lawhon N., Harisdangkul V., Malignant tumor with chest wall pain mimicking Tietze's syndrome, Clin Rheumatol., 2001; 20(4):276-8</ref><ref name="Moin et al">Moin P., Vergouw M., Imanuel N., Hulshof D., 2005, Syndroom van Tietze, geraadpleegd op 26/12/2010, http://www.fysiotherapie-enschede.nl/content/ziektenbeelden3upo/Syndroom%20van%20Tietze.htm</ref> Only when a swelling occurs underneath sternum and/or a reddening of the skin at the painfull spot, it's called Tietze's syndrome<ref name="Verdon et al">Verdon F., Burnand B., Herzig L., Junod M., Pécoud A., Bernard F., Chest wall syndrome among primary care patients: a cohort study, Fam Pract., 2010 Aug; 27(4):363-9</ref><ref name="Hoogendoorn et al">Hoogendoorn R.J., Brinkman J.M., Visser O.J., Paul M.A., Wuisman P.I., Sternal pain: not always harmless, Ned Tijdschrift Geneeskd. 2004 Dec 11;148(50):2469-74</ref><ref name="American academy of family physicians">American acadamy of family physicians, Costochondritis: What you need to know, Am Fam Physicians, Sept 2009, 15;75(10):1</ref><ref name="Hurst et al">Hurst J.W., Morris D.C., Williams B.R. “Chest Pain” in patients with costochondritis or Tietze's syndrome, Wiley-Blackwell, 2001, p23-29</ref>. This disease causes severe pain when coughing and deep breathing. The Tietze's syndrome is not life-threatening or contagious but it is a fastidious and painfull disease.<ref name="Verdon et al" /><ref name="Moin et al" /> Costochondritis<ref name="American academy of family physicians" /> and the Tietze's syndrome are often confused but in fact they are two different diseases. <ref name="Proulx and Zryd" />
[[Costochondritis|Costochondritis]] is a painfull chronical inflammation of the cartilago of one or more costae at <br>the transition between sternum and costae.<ref name="Fam and Smythe">Fam A.G., Smythe H.A.,Musculoskeletal chest wall pain, Can Med Assoc J. Sept 19851; 133(5):379-389.</ref><ref name="Thongnarm et al">Thongngarm T., Lemos L.B., Lawhon N., Harisdangkul V., Malignant tumor with chest wall pain mimicking Tietze's syndrome, Clin Rheumatol., 2001; 20(4):276-8</ref><ref name="Moin et al">Moin P., Vergouw M., Imanuel N., Hulshof D., 2005, Syndroom van Tietze, geraadpleegd op 26/12/2010, http://www.fysiotherapie-enschede.nl/content/ziektenbeelden3upo/Syndroom%20van%20Tietze.htm</ref> Only when a swelling occurs underneath sternum and/or a reddening of the skin at the painfull spot, it's called Tietze's syndrome<ref name="Verdon et al">Verdon F., Burnand B., Herzig L., Junod M., Pécoud A., Bernard F., Chest wall syndrome among primary care patients: a cohort study, Fam Pract., 2010 Aug; 27(4):363-9</ref><ref name="Hoogendoorn et al">Hoogendoorn R.J., Brinkman J.M., Visser O.J., Paul M.A., Wuisman P.I., Sternal pain: not always harmless, Ned Tijdschrift Geneeskd. 2004 Dec 11;148(50):2469-74</ref><ref name="American academy of family physicians">American acadamy of family physicians, Costochondritis: What you need to know, Am Fam Physicians, Sept 2009, 15;75(10):1</ref><ref name="Hurst et al">Hurst J.W., Morris D.C., Williams B.R. “Chest Pain” in patients with costochondritis or Tietze's syndrome, Wiley-Blackwell, 2001, p23-29</ref>. This disease causes severe pain when coughing and deep breathing. The Tietze's syndrome is not life-threatening or contagious but it is a fastidious and painfull disease.<ref name="Verdon et al" /><ref name="Moin et al" /> Costochondritis<ref name="American academy of family physicians" /> and the Tietze's syndrome are often confused but in fact they are two different diseases. <ref name="Proulx and Zryd" />
 
Costochondritis usually affects the third, fourth and fifth costochondral joint and occurs more often in women. whereas Tietze’s syndrome most commonly affects one joint, in particularly the second or third costal cartilage and both sexes are affected equally<ref>Anthony S. Fauci, Carol A. Langford. Harrison’s rheumatology. Second edition. 2010. McGraw-Hill Education</ref> . Both diseases can start either acute or progressively at any age<br><br>


== Clinically Relevant Anatomy  ==
== Clinically Relevant Anatomy  ==

Revision as of 22:10, 25 May 2011

Welcome to Vrije Universiteit Brussel's Evidence-based Practice project. This space was created by and for the students in the Rehabilitation Sciences and Physiotherapy program of the Vrije Universiteit Brussel, Brussels, Belgium. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!

Original Editors - Els Bernaers

Lead Editors - Your name will be added here if you are a lead editor on this page.  Read more.

Search Strategy[edit | edit source]

add text here related to databases searched, keywords, and search timeline

Definition/Description[edit | edit source]

Costochondritis is a painfull chronical inflammation of the cartilago of one or more costae at
the transition between sternum and costae.[1][2][3] Only when a swelling occurs underneath sternum and/or a reddening of the skin at the painfull spot, it's called Tietze's syndrome[4][5][6][7]. This disease causes severe pain when coughing and deep breathing. The Tietze's syndrome is not life-threatening or contagious but it is a fastidious and painfull disease.[4][3] Costochondritis[6] and the Tietze's syndrome are often confused but in fact they are two different diseases. [8]

Costochondritis usually affects the third, fourth and fifth costochondral joint and occurs more often in women. whereas Tietze’s syndrome most commonly affects one joint, in particularly the second or third costal cartilage and both sexes are affected equally[9] . Both diseases can start either acute or progressively at any age

Clinically Relevant Anatomy[edit | edit source]

add text here

Epidemiology /Etiology[edit | edit source]

add text here

Characteristics/Clinical Presentation[edit | edit source]

add text here

Differential Diagnosis[edit | edit source]

The cartilage connects sternum with costae and clavicula, and makes the movement of the thorax possible while the breathing.[1][3] The inflammation of the the cartilage of one or more costae causes a swelling of the cartilago and a red, warm swelling will be visible and palpable.[7][3]There is pain with a varying intensity in the chest wall and this pain aggravated by movements of the torso, deep breathing, coughing and exertion. [8][4][1][7] Pain occurring during the palpation of the painfull spot suggests costochondritis but the pain could have a cardiac origin[8][4] tumor[4][5][1],... [3] Other investigations like electrocardiography[1][3], CT-scan[10][5], MRI[11][5][1],… are necessary. Through the pain of inflammation, the normal movement in joints are disrupted, the movements of the shoulder crepitates or pain may occur.[4][1][3] Complaints occur gradually and can disappear spontaneously after some days but it may take years to disappear.[12][1] Even after a spontaneously healing the complaints can return on the same place or another spot around the costae.[1][7]

Diagnostic Procedures[edit | edit source]

add text here related to medical diagnostic procedures

Outcome Measures[edit | edit source]

add links to outcome measures here (also see Outcome Measures Database)

Examination[edit | edit source]

add text here related to physical examination and assessment

Medical Management
[edit | edit source]

add text here

Physical Therapy Management
[edit | edit source]

The treatment of Tietze’s syndrome is not yet perfect. It is not known weather the disease is dealed definitly or not.[3] There are not yet trustworthy clinical studies on the treatment of Tietze’s syndrome[8][4][6]. For now, the treatment consist:
- pain medication (NSAID)[6] or eventually an injection on the painfull spot,[8][12][1][3]
The physiotherapist can:
- reassure the patient by explaining the condition [8][4]
- instruct a good body position and give exercise advise. Patients need a good balance between exercise and rest.[8][12][7][6]
- use heat pads and massage to help against the overloading of muscles and tot temper the pain.[8][1][6]
- mobilize spine and ribs to avoid rigidity of the thorax and to reduce complaints.[12][3]
- teach the patient breathing excercises[3]
- learn the patient to handle with pain. Which movements are provocative?[8][6]
Excercise for shoulder and back can be provocative, only when the complaints have disappeared, vthey can be applied.[3]

Key Research[edit | edit source]

add links and reviews of high quality evidence here (case studies should be added on new pages using the case study template)

Resources
[edit | edit source]

add appropriate resources here

Clinical Bottom Line[edit | edit source]

add text here

Recent Related Research (from Pubmed)[edit | edit source]

see tutorial on Adding PubMed Feed

Extension:RSS -- Error: Not a valid URL: Feed goes here!!|charset=UTF-8|short|max=10

References[edit | edit source]

see adding references tutorial.

  1. ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 Fam A.G., Smythe H.A.,Musculoskeletal chest wall pain, Can Med Assoc J. Sept 19851; 133(5):379-389.
  2. ↑ Thongngarm T., Lemos L.B., Lawhon N., Harisdangkul V., Malignant tumor with chest wall pain mimicking Tietze's syndrome, Clin Rheumatol., 2001; 20(4):276-8
  3. ↑ 3.00 3.01 3.02 3.03 3.04 3.05 3.06 3.07 3.08 3.09 3.10 3.11 Moin P., Vergouw M., Imanuel N., Hulshof D., 2005, Syndroom van Tietze, geraadpleegd op 26/12/2010, http://www.fysiotherapie-enschede.nl/content/ziektenbeelden3upo/Syndroom%20van%20Tietze.htm
  4. ↑ 4.0 4.1 4.2 4.3 4.4 4.5 4.6 4.7 Verdon F., Burnand B., Herzig L., Junod M., Pécoud A., Bernard F., Chest wall syndrome among primary care patients: a cohort study, Fam Pract., 2010 Aug; 27(4):363-9
  5. ↑ 5.0 5.1 5.2 5.3 Hoogendoorn R.J., Brinkman J.M., Visser O.J., Paul M.A., Wuisman P.I., Sternal pain: not always harmless, Ned Tijdschrift Geneeskd. 2004 Dec 11;148(50):2469-74
  6. ↑ 6.0 6.1 6.2 6.3 6.4 6.5 6.6 American acadamy of family physicians, Costochondritis: What you need to know, Am Fam Physicians, Sept 2009, 15;75(10):1
  7. ↑ 7.0 7.1 7.2 7.3 7.4 Hurst J.W., Morris D.C., Williams B.R. “Chest Pain” in patients with costochondritis or Tietze's syndrome, Wiley-Blackwell, 2001, p23-29
  8. ↑ 8.0 8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 Proulx A.M., Zryd T.W., Costochondritis; Diagnosis and Treatment, Am Fam Physician, 2009 Sep 15;80(6):617-20
  9. ↑ Anthony S. Fauci, Carol A. Langford. Harrison’s rheumatology. Second edition. 2010. McGraw-Hill Education
  10. ↑ Hamburg C., Abdalwahab I.F., Reliability of computed tomography in the initial diagnosis and follow-up evaluation of Tietze's syndrome: a case report with review of the literature, J Comput Tomogr., 1987;11(1):83-87
  11. ↑ Volterrani L., Mazzei M.A., Giordano N., Nuti R., Galeazzi M., Fioravanti A., Magnetic resonance imaging in Tietze's syndrome, Clin Exp Rheumatol., Sept-Oct 2008; 26(5):848-53
  12. ↑ 12.0 12.1 12.2 12.3 Gregory P.L., BISWAS A.C., Batt M.E.,Musculoskeletal problems of the chest wall in athletes, Sports Med., 2002;32(4):235-50.
Retrieved from "https://www.physio-pedia.com/index.php?title=Tietzes&oldid=39729"