Among the many diverse diseases of the chest cavity, pathology is quite often found, which can easily be confused with diseases of the lungs and heart, inflammatory processes in the bones and muscles of an infectious and allergic nature, as well as purulent infections - such terrifying clinical manifestations are inherent in it. However, in reality, the severity of the symptoms is completely inconsistent with the severity of the phenomena occurring in the chest. This is a little-known disease - rib chondritis, which in medicine is often called Titz syndrome.
brief information
Literally, “chondritis” means cartilage inflammation, but in reality, physicians designate with this concept any unspecified pathology that occurs in the cartilage layer.
As is known from the anatomy, the end section of the ribs connected to the sternum is based precisely on such tissue, and it is here that the disease develops.
- Most often, the disease affects the second rib.
- The third and fourth ribs are less often covered.
- And with only a 10% chance of illness, the first, fifth or sixth rib lends itself.
Both men and women are equally affected by this disease. Most often, rib 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, in whose honor, in fact, got its name. By the way, in the medical literature one more name for the disease is often found - perichondritis.
The main manifestation of the pathology, the German doctor called pain in the chest, in the middle of the ribs. But today, doctors say about the many other symptoms that accompany the disease.
Causes of occurrence
Presumably, Titz syndrome can be triggered:
- regular ARVI, especially complicated bronchitis;
- bouts of debilitating cough, which almost loosens the chest;
- systematic sports loads and rib injuries;
- drug addiction and alcoholism;
- poor nutrition with a minimum amount of collagen, calcium and vitamins;
- metabolic disorders;
- 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 fever, sweating and hyperemia, but is characterized by a completely asymptomatic course. This is one of the main dangers of the disease.
But despite the absence of obvious signs, cartilage undergoes structural changes. In this case, they occur:
- deposition of calcium salts;
- metaplastic and hyperplastic phenomena;
- dystrophy, accompanied by the formation of a vacuole;
- modification of bone partitions;
- the introduction of cartilage into bone tissue.
Signs of illness
It is very important to know exactly what the symptoms of Tietze syndrome look like . Treatment of the pathology is carried out, regardless of clinical manifestations, but such information will help to respond to alarm 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, according to which you can suspect the presence of this disease in the body.
- Acute pain in the lower and left chest pseudo-religious nature, disguised as heart pain.
- A few hours or a day after the onset of pain over a damaged rib, a swelling may form, giving pain on palpation.
- When you inhale, the pain increases significantly, exactly like with cough, chest mobility and palpation of the costal connection with the sternum.
- Irradiation of unpleasant sensations into the neck, shoulder blades, clavicle and arm is likely. This phenomenon is due to damage to the intercostal nerve, which is optional and does not always accompany pathology.
The main sign of the disease, which should alert the patient, is pain in the chest with a deep breath. It is this symptom that should become the reason for the speedy visit to the doctor.
Diagnosis of the disease
The main technique for detecting costal chondritis is radiography. With its help, you can find the following picture:
- the club-shaped form of the injured rib, which appeared against the background of periostitis;
- its hyperplasia - an increase in parameters compared with healthy ribs;
- asymmetric calcification zones on the surface of bone bases;
- visualization of sterno-costal joints as bright spots and thickenings due to ongoing dystrophic processes - usually, healthy cartilage does not manifest itself on X-ray.
If suspicious symptoms are often detected in the picture, often observed in the early stages of the development of Titz 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 necessary to exclude more dangerous cardiac and respiratory defects. Such differential diagnosis is very important, because similar symptoms are an invariable component of all pathological processes that occur in the thoracic region.
What diseases can be confused with the syndrome?
First of all, a specialist should exclude diseases of the respiratory apparatus and the cardiovascular system. Then, differential diagnosis is performed with pathologies that give similar signs:
- rib arthritis;
- osteochondritis;
- costal exostosis;
- osteomyelitis;
- post-traumatic callus, forming in the area of the fracture of the rib.
Titz syndrome treatment
Symptoms of costal chondritis often scare patients with its vivid expression. However, in fact, this disease does not carry a great danger and is treated, as a rule, using conservative techniques. When the first signs of pathology occur, a mandatory regime is introduced to limit physical activity on the damaged area.
The main principle of treatment is eryotropic: in order to stop chest pains in the middle and on the left side, you just need to get rid of the main provoking factors. We are talking about debilitating exercises, frequent colds, physical exertion associated with professional and domestic activities, addictions in the form of addiction to drugs, alcohol and tobacco, malnutrition and nutritional imbalance.
If the patient has chest pain with a deep breath and mobility, symptomatic therapy is needed. Pain is eliminated by:
- non-steroidal anti-inflammatory drugs;
- local blockade anesthesia;
- iodine drugs and salicylates.
The 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 a combination of them with salicylates taken orally.
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
The treatment of costal chondritis with the use of low current, x-ray and ultrasound radiation, as well as dry heat helps patients well. Doctors often recommend such physiotherapeutic procedures to patients:
- UHF;
- acupuncture;
- electrophoresis using potassium iodide;
- x-ray therapy;
- applying ozokerite and hot paraffin to damaged areas.
Climate treatment has a beneficial effect on the affected ribs:
- sunburn in the morning;
- swimming in the sea;
- walks on the beach and in the forest.
Physiotherapy
Quite quickly, you can get rid of the bothering pain when you inhale and other unpleasant symptoms with the help of daily physical education. Such exercises are designed specifically for the thoracic region and are based on movements that do not load the joints, but at the same time affect them.
Extremely useful respiratory gymnastics, which must be performed in parallel with ordinary gymnastics. At the same time, it is very important to correctly configure breathing by connecting the abdominal and pectoral muscles to the process.
To stabilize the tone of the breast tissue and eliminate the symptoms of costal chondritis, static exercises, which are required for deep muscle relaxation, are recommended. The patient should check with the specialist about the rules for therapeutic exercises.
Surgical intervention
The need for surgery for Titz syndrome is extremely rare. Indications for surgical intervention are:
- regular rib fractures;
- lack of results from the use of conservative techniques;
- chronic form of pathology.
In the presence of such conditions, the patient may be assigned a resection of the cartilaginous periosteum at the attachment point of the ribs to the spine.
Home therapy
It is worth saying that the pathological process that occurs in the ribs, it is simply impossible to eliminate using folk recipes. External compresses and ointments are also ineffective in such a disease. After all, the beneficial elements contained in such funds will simply not reach the affected cartilage and receptors. In addition, applying a hot compress to the left chest area is prohibited.
But it is still possible to minimize pain sensations that occur with costal chondritis using folk remedies. For this purpose fit:
- a solution of mummy in milk or water;
- herbs with soothing and analgesic properties - mint, lemon balm, chamomile, oregano, calendula;
- warm herbal baths using lavender, fir or eucalyptus oil.
Forecast
Costal chondritis, as a rule, is quite well amenable to therapy and does not pose a serious danger to the health and especially 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 already happened bone deformations are irreversible.
Titz syndrome is quite capable of recurring even after decades. So patients who have once been diagnosed with this disease should be systematically examined.