Although Tietze1 reported the syndrome
of painful enlargement of the costal cartilages
in 1921, this condition received little attention
in American literature until recently.
Tietze's original description of 5 cases has
been followed by reports of more than 160
other examples of the same disease. The
first American paper on Tietze's syndrome
was written in 1953, and subsequently there
have been at least five additional major
papers produced in this country.
Tietze disease has been variously referred
to as the costochondral syndrome, painful
swelling of the chondrocostal region, costal
chondritis, stress fracture of upper ribs,
and prominent costal cartilages. Since the
pathogenesis of the disease is unknown, the
eponym designation is useful at the present.
Tietze originally suggested that tuberculosis
or wartime malnutrition might have been
etiologic factors. Subsequent authors have
proposed that buckling of the cartilage due
to an inflammatory reaction in the ligaments
immediately behind it,2 trauma to
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