Among the many different diseases of the chest cavity, quite often there is a pathology that can be easily confused with diseases of the lungs and heart, inflammatory processes in the bones and muscles of an infectious and allergic nature, as well as with purulent infections - such terrifying clinical manifestations are inherent her. However, in reality, the severity of the symptoms does not correspond at all to the severity of the phenomena occurring in the chest. This is a little-known disease - costal chondritis, which in medicine is often called Tietze's syndrome.
At a Glance
Literally, "chondritis" means cartilage inflammation, but in reality, doctors refer to this concept as any unspecified pathology that occurs in the cartilage layer.
As is known from anatomy, the end section of the ribs, connected to the sternum, is based on precisely such tissue, and this is where the disease develops.
- Most often the disease affects the second rib.
- Third and fourth edges covered less frequently.
- And with only a 10% chance of illness, the first, fifth or sixthrib.
Both men and women are equally affected by this disease. Most often, costal chondritis is diagnosed in people aged 20-40 years. That is why doctors consider this pathology a disease of the young.
The defect was described in 1921 by the German surgeon Tietze, after whom, in fact, it got its name. By the way, in the medical literature there is often another name for the disease - perichondritis.
The main manifestation of the pathology, the German doctor called pain in the chest, in the middle of the ribs. But today, doctors are talking about many other symptoms that accompany the disease.
Causes of occurrence
Presumably Tietze's syndrome can be provoked:
- regular SARS, especially complicated by bronchitis;
- bouts of a debilitating cough that practically loosens the thoracic region;
- systematic sports loads and rib injuries;
- drug addiction and alcoholism;
- poor nutrition with minimal amounts of collagen, calcium and vitamins;
- disorders in metabolism;
- thoracotomy - an operation involving the opening of the chest cavity.
Etiology
By conducting microbiological studies, information was obtained that aseptic inflammation arises in cartilage damaged by costal chondritis. This is a pathology that is not accompanied by an increase in temperature,sweating and hyperemia, and is characterized by a completely asymptomatic course. This is one of the main dangers of the disease.
But despite the lack of obvious signs, cartilage undergoes structural changes. At the same time, the following occurs in them:
- deposition of calcium s alts;
- metaplastic and hyperplastic phenomena;
- dystrophy accompanied by the formation of vacuoles;
- modification of bony septa;
- implantation of cartilage into bone tissue.
Signs of illness
It is very important to know exactly what the symptoms of Tietze's syndrome look like. Treatment of pathology is carried out, regardless of clinical manifestations, but such information will help to respond to alarming signs in time and consult a doctor. No wonder the timeliness of diagnosis is rightly considered a guarantee of the effectiveness of further therapy.
There are several main symptoms of costal chondritis, which can be used to suspect the presence of this disease in the body.
- Sharp pain in the lower and left chest of a pseudoangiotic nature, masquerading as heart pain.
- A few hours or a day after the onset of pain, a swelling may form over the damaged rib, giving pain on palpation.
- When inhaling, the pain increases significantly, exactly as with coughing, chest mobility and probing the rib connection with the sternum.
- The irradiation of unpleasant sensations in the neck, shoulder blades, collarbone and arms is quite likely. This phenomenon is due to the lossintercostal nerve, which is optional and does not always accompany pathology.
The main symptom of the disease, which should alert the patient, is pain in the chest with a deep breath. It is this symptom that should be the reason for an early visit to the doctor.
Diagnosis of disease
The main method for detecting costal chondritis is radiography. With its help, you can detect the following picture:
- club-shaped form of an injured rib, which appeared against the background of periostitis;
- his hyperplasia - an increase in parameters compared to he althy ribs;
- asymmetric zones of calcification on the surface of bone bases;
- visualization of the sternocostal joints as light spots and thickening due to ongoing dystrophic processes - usually, he althy cartilage does not show up on x-rays.
If suspicious symptoms are detected in the picture, often observed in the early stages of the development of Tietze's syndrome, it is advisable to undergo computed tomography or magnetic resonance imaging, which allows you to clearly visualize even the initial manifestations of the pathology.
An electrocardiogram and laboratory tests are needed to rule out more dangerous heart and respiratory malformations. Such a differential diagnosis is very important, because similar symptoms are an invariable component of all pathological processes occurring inthoracic region.
What diseases can the syndrome be confused with
First of all, the specialist must exclude diseases of the respiratory apparatus and the cardiovascular system. Then differential diagnosis is carried out with pathologies that give similar signs:
- rib arthritis;
- osteochondritis;
- costal exostosis;
- osteomyelitis;
- post-traumatic callus forming in the area of rib fracture.
Titze's syndrome treatment
Symptoms of costal chondritis often frighten patients with their vivid severity. However, in reality, this disease does not pose a great danger and is usually treated with the help of conservative methods. When the first signs of pathology appear, a mandatory mode of limiting physical activity on the damaged area is introduced.
The main principle of treatment is eriotropic: in order to stop pain in the chest in the middle and on the left side, you simply need to get rid of the main provoking factors. We are talking about exhausting exercises, frequent colds, physical stress associated with professional and domestic activities, addictions in the form of addiction to drugs, alcohol and tobacco, nutritional deficiencies and imbalances.
If the patient has chest pain with deep inspiration and mobility, symptomatic therapy is necessary. Pain syndrome is eliminated with:
- non-steroidal anti-inflammatory drugs;
- local block anesthesia;
- iodinedrugs and salicylates.
Blockade involves the use of a 0.5% solution of novocaine and hydrocortisone. A total of 4-5 such injections for pain are allowed.
Iodine preparations are allowed to be used only in minimal dosages. Probably combining them with oral salicylates.
As for anti-inflammatory drugs, they can be used in the form of tablets and injections. Various gels and ointments of the same spectrum of action also help with pain.
Physiotherapy
Patients are well helped by the treatment of costal chondritis with the use of weak current, X-ray and ultrasound radiation, as well as dry heat. Doctors often recommend the following physical therapy treatments to patients:
- UHF;
- acupuncture;
- electrophoresis using potassium iodide;
- radiotherapy;
- applying ozocerite and hot paraffin to damaged areas.
Climatic treatment has a beneficial effect on the affected ribs:
- sun tan in the morning;
- swimming in the sea;
- walks on the beach and in the forest.
Therapeutic gymnastics
Pretty quickly get rid of annoying pain when inhaling and other unpleasant symptoms with the help of daily physical education. Such exercises are designed specifically for the thoracic region and are built on movements that do not burden the joints, but at the same timeaffecting them.
Extremely useful is respiratory exercise, which must be performed in parallel with ordinary gymnastics. At the same time, it is very important to correctly adjust the breathing by connecting the abdominal and pectoral muscles to the process.
To stabilize the tone of breast tissues and eliminate the symptoms of costal chondritis, static exercises are recommended, which are required for deep muscle relaxation. The patient should check with a specialist about the rules for conducting therapeutic exercises.
Surgery
The need for surgery in Tietze's syndrome is extremely rare. Indications for surgical intervention are:
- regular rib fractures;
- lack of result from the use of conservative methods;
- chronic form of pathology.
In the presence of such conditions, the patient may be assigned a resection of the cartilaginous periosteum at the site of attachment of the ribs to the spine.
Home Therapy
It is worth saying that the pathological process that occurs in the ribs is simply impossible to eliminate with the help of folk recipes. Ineffective in such a disease are also external compresses and ointments. After all, the useful elements contained in such products simply will not reach the affected cartilage and receptors. In addition, applying a hot compress to the left chest area is prohibited.
But to minimize the pain that occurs with costal chondritis with the help of folk remedies all-still possible. Suitable for this purpose:
- mummy solution in milk or water;
- herbs with soothing and analgesic properties - mint, lemon balm, chamomile, oregano, calendula;
- warm herbal baths with lavender, fir or eucalyptus oil.
Forecast
Costal chondritis, as a rule, responds quite well to therapy and does not pose a serious danger to he alth, let alone the life of the patient. That is why the prognosis for this pathology is almost always favorable. With appropriate treatment, the elimination of harmful factors, the pathological process in the damaged ribs stops. But bone deformities that have already occurred are irreversible.
Tietze's syndrome is quite capable of recurring even decades later. So patients who have once been diagnosed with this disease should be systematically examined.
