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Published on: August 15, 2019
[Tietze's syndrome in a 2-year old boy]
J M Pijning1, H de Boeck, B Desprechins
1Afd. Kindergeneeskunde, Academisch Ziekenhuis Kinderen van de Vrije Universiteit Brussel, België. j.m.pijning@amc.uva.nl
Insights
Tietze's syndrome, a painful chest swelling, can affect children and typically resolves on its own. Early recognition prevents unnecessary medical interventions for this benign condition.
Area of Science:
- Pediatric Rheumatology
- Medical Imaging
Background:
- Tietze's syndrome is a rare, benign inflammatory condition causing localized swelling of costosternal or costochondral joints.
- While typically seen in adults, it can occur in children, presenting diagnostic challenges.
Observation:
- A 2-year-old boy presented with painful swelling of the left costochondral junction.
- Imaging revealed swelling in the 4th and 5th costochondral junctions and pectoral muscle, with no signs of infection.
- A conservative, 'wait-and-see' approach was adopted due to suspected Tietze's syndrome.
Findings:
- Symptoms gradually subsided over a 10-week period.
- Final examination showed only slight, painless swelling with normal ultrasound findings.
- The case illustrates the characteristic spontaneous regression of Tietze's syndrome.
Implications:
- Accurate diagnosis of Tietze's syndrome in children is crucial to avoid invasive procedures.
- Understanding the benign and self-limiting nature of this condition aids clinical management.
- Knowledge of Tietze's syndrome outcomes can improve patient care and reduce healthcare costs.
Abstract:
A 2-year-old boy was seen with a painful swelling of the left costochondral junction. Laboratory examination revealed no signs of infection. Echography and CT-scan revealed swelling of the 4th and 5th costochondral junction and the pectoral muscle. Tietze's syndrome was suspected and a wait-and-see policy was decided on. During follow-up, the symptoms gradually decreased. Ten weeks after the onset of symptoms there was only a slight, painless swelling with normal ultrasound findings. Tietze's syndrome is defined as a benign, painful, non-suppurative and localised swelling of the costosternal, costochondral or sternoclavicular joints with spontaneous regression of symptoms. It is typically described in adults but appears in children and infants as well. Recognition of this syndrome and knowledge of its favourable outcome can prevent invasive diagnostic procedures.
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