Thoracic outlet syndrome. Bird syndrome in humans

Most doctors believe that Tietze syndrome can be completely cured only with the help of surgical intervention(subperiosteal resection), but it is performed in in rare cases. If severe pain does not bother the patient for a long time, then therapy comes down to conservative methods:

A variety of creams and ointments that have an anti-inflammatory effect.
Compresses using dimexide.
Reflexology and physiotherapy.
Blockade of intercostal nerves using novocaine.
Analgesics and non-steroidal anti-inflammatory drugs.
Injections of steroids and anesthetics into pain points.

Of course, the methods of therapy described above do not help get rid of pathological formation, which appeared in the ribs, but they reduce swelling, relieve inflammation, and improve general condition.

Medicines

Apizartron. An ointment based on the action of several active components: bee venom, allyl isothiocyanate and methyl salicylate. Thanks to the use of this drug, metabolism in tissues and muscles improves, muscle tone decreases.

To receive effective result It is necessary to apply a small strip of ointment (about 5 cm) to the affected area and distribute it evenly over the entire surface. You need to wait until a feeling of warmth appears and then light movements rub into the skin. Typically used up to three times a day until pain subsides.

Among the side effects, only allergic reactions(itching sensation, rash, redness). Contraindications for use are: pregnancy and breast-feeding, skin diseases, liver disease, chronic renal failure, mental illness, arthritis, children under 12 years old.

Dimexide. Active active substance drug - dimethyl sulfoxide. Has a pronounced anti-inflammatory effect. It also has a local anesthetic and antimicrobial effect.

Used externally for compresses or dressings. To reduce pain, apply a compress every day (until the pain disappears). In this case, a 25% dimexide solution is used.

The most common side effects from using the drug are: nausea, bronchospasms, allergies, itching, vomiting, redness. Contraindicated in acute and chronic diseases of the liver and kidneys, atherosclerosis, angina pectoris, stroke, pregnancy, intolerance to the main components.

Piroxicam. This is a non-steroidal anti-inflammatory drug that belongs to oxicams. It has a good anti-inflammatory, antipyretic and analgesic effect. Usually the result is noticeable within 30 minutes after taking the tablet.

Taken once a day. Sometimes side effects may occur after taking: poor appetite, nausea, bleeding from the gums, constipation or diarrhea, anemia, headaches, dizziness, depression, hallucinations, insomnia, allergies. The drug should not be taken if peptic ulcer stomach and duodenum, in the first trimester of pregnancy, children under 14 years of age, proctitis, liver or kidney diseases.

Physiotherapy

Laser therapy – a laser beam affects the affected areas. The course consists of ten sessions, which last about ten minutes.
Electrophoresis with the use of drugs - through skin various drugs with an analgesic effect are administered (using electric current). The course consists of ten sessions lasting no more than five minutes.
Therapy ultraviolet rays– the affected area is treated with an electric field with high frequency. The course consists of 10-15 sessions, which last 5-10 minutes (depending on the patient’s condition).
Darsonvalization - low currents with high voltage and frequency are used. The course consists of ten sessions of 5-10 minutes each.

Traditional treatment

In some cases, traditional medicine helps to relieve the symptoms of Tietze syndrome. Patients use:

Baths to improve your condition.
Herbal compresses.
Decoctions.
Various rubbing into the skin.

To accept medicinal bath, necessary in warm water(5 liters) dilute 300 g of chamomile. Infuse the broth and then strain. Pour into the bath. It is recommended to take water procedures for no more than 20 minutes daily. You can replace chamomile with spruce branches or sage.

Compresses, as a rule, are made from the following herbs: steamed lemon balm leaves, sage, horseradish. You need to tie a shawl on top of the compress to retain heat. Good result showed rubbing pork or bear fat into sore spots. Some patients use tinctures based on alcohol and birch buds or eucalyptus for rubbing.

Herbal treatment

Decoctions are used in the treatment of Tietze syndrome, usually to increase immune protection body and improve blood circulation. To prepare such decoctions the following are used:

Sage.
Yarrow.
St. John's wort.
Nettle root.
Thyme.
Juniper (fruit).

The most popular recipes using herbs are:

Take three tablespoons of birch leaves and pour 600 ml of boiling water, leave for eight hours and strain. Drink 200 ml two to three times a day.
Take one tablespoon of lingonberry leaves and pour 200 ml cold water. Bring to a boil over heat and let simmer for ten minutes. Cool and strain. Drink one tablespoon three to four times a day. Can be stored in a cool place for 24 hours.
Take 20 g of elderberry flowers and place in a clay or porcelain bowl, pour in 1 liter of boiling water, and leave overnight. Divide the tincture into three equal parts and drink them in one day.

Surgical treatment

Subperiosteal resection is used to treat Tietze syndrome. Surgery is an extremely rare method. It is carried out only if conservative treatment has been unsuccessful. The operation is performed in a hospital under local or general anesthesia.

The chest limits chest cavity and consists of vertebrae, ribs and sternum. Vital vessels and nerves pass into the chest cavity through openings - apertures. There are two of them in the chest: upper and lower.

The superior thoracic outlet is the opening at the top of the chest. The walls of this hole are: first thoracic vertebra(VertebraeThoracicae 1), first rib (CostaPrima), clavicle (Clavicula), as well as adjacent muscles (mostly musculus scalenus anterior) and fascia.

This anatomical formation is an integral part normal functioning human body. It includes the upper (apical) parts of the lung, blood vessels, nerves, trachea, esophagus, etc.

Due to certain factors, the vessels and nerves passing through the opening can become pinched, which leads to the development of thoracic outlet syndrome.

Etiology and pathogenesis of pathology

The cause and initiator of the pathology is infringement of the neurovascular bundle. Compression can be caused by a fracture of the first rib or collarbone, displacement of the vertebrae, prolonged forced positioning, work in which the upper limbs are constantly in motion, surgical interventions and procedures.

Most often, nerve compression occurs, which is explained by mechanical narrowing of the nerve fiber, which leads to symptoms.

Venous and arterial strangulation occurs less frequently. In this case, not only mechanical compression of the vessel plays a role in pathogenesis, but also subsequent thrombus formation.

An uncontrolled process can lead to serious consequences.

Symptoms and complaints of VAHA syndrome

Manifestations of pathology depend on which structure is most damaged. Most often, a nerve is pinched, which leads to a tingling feeling in the hand, pain, lack of sensitivity, impaired movement, deterioration of micromotility of the fingers, severe fatigue in hand.

Vascular symptoms, although less common, are fraught with more severe consequences. If a vein is pinched, the arm may swell and there will be severe pain and feeling high pressure, numbness. Arterial compression can lead to cyanosis of the limb, pain, numbness, and loss of sensitivity. If symptoms are ignored for a long time, strangulation will cause ischemic changes and soft tissue necrosis.

A medical examination of a patient begins with a survey. Patients rarely complain of all of the above symptoms, because the symptoms of this syndrome are very vaguely expressed and the patient may associate the symptoms with something else (“sleeping” his arm at night, working hard at a construction site, etc.).

The doctor's main method when examining a patient is the Edson maneuver. This test is performed quite easily: the patient raises his hand above his head, after 15 seconds the doctor begins palpating the radial artery in the wrist area. If pulsation is not palpable, the test is considered positive.

After a preliminary examination, the patient is sent for additional studies. Magnetic resonance imaging is of great diagnostic importance, because its results can best determine the compression of blood vessels and nerves in the upper aperture.

X-rays, computed tomography (since this method better identifies bone lesions rather than soft tissue lesions), Dopplerography, ultrasound, phlebography, arteriography, and nerve conduction test are considered secondary.

Therapy for the syndrome depends on the symptoms and causes of their occurrence. In case of a fracture of the bony part of the aperture, adequate immobilization of the fracture should be carried out. If the fracture is comminuted, surgery is indicated.

Injury due to muscle inflammation requires the use of anti-inflammatory drugs.

Pressing, dull pain in the upper part of the sternum, radiating to the shoulders, shoulder blades, arms, often indicates a lesion cartilage tissue ribs, development of Tietze syndrome. Against the background of autoimmune pathologies, infectious diseases, with constant heavy physical exertion on top part body, respiratory diseases, an inflammatory process develops.

Why is perichondritis dangerous? How to recognize Tietze syndrome at an early stage? How to treat inflammation of the cartilage tissue of the ribs? The answers are in the article.

What is it

Perichondritis (Tietze syndrome, costochondritis) - pathology, characteristic feature which is inflammation of the cartilage in the ribs. When the disease occurs, doctors identify damage to the upper chest. The inflammation is benign in nature; a different number of ribs are involved in the pathological process.

The main sign is pain syndrome at the top of the sternum. Discomfort spreads to nearby areas and intensifies with various types of stress. Cartilage damage develops against the background of pathologies that disrupt metabolism. The German surgeon A. Tietze first described perichondritis in 1921.

Causes

Pathology develops much less frequently than or, doctors cannot say with 100% certainty what gives impetus to the activation of the pathological process in cartilage. Most doctors believe that perichondritis is a consequence of a disorder metabolic processes, which leads to disruption of the structure and functions of connective tissue.

The risk of developing costochondritis increases if the following factors are present:

chronic pathologies of infectious nature;
every day a person performs work, during which the load falls on shoulder girdle, arms and chest;
microtraumas due to frequent chest contusions, for example, in athletes;
arthritis and arthrosis of various etiologies;
high sensitization of the body, severe reaction to allergens;
acute and chronic pathologies respiratory tract accompanied by a strong cough;
autoimmune pathologies;
surgery was performed in the sternum area;
collagenosis;
any pathologies that disrupt fat, mineral, lipid, and salt metabolism;
diseases, against the background of which immunity sharply decreases.

Tietze syndrome code according to ICD - 10 - M94.0.

First signs and symptoms

The main sign is painful sensations in the chest area and surrounding areas. Discomfort varies in intensity. Others characteristic symptoms the disease does not, diagnosing Tietze syndrome is quite difficult. It is important to differentiate perichondritis from other diseases of bone and cartilage tissue.

Doctors pay attention to pain that develops with active palpation of the area where the ribs attach. If palpable pain appears when pressing on this area, then an inflammatory process in the elastic cartilaginous tissue is likely to develop.

With costochondritis, other manifestations are possible:

pain increases with coughing and deep breaths;
discomfort is felt in the front of the sternum;
the most severe pain occurs in the area of the fifth or sixth rib;
with active inflammatory process the affected area swells, the formation is quite dense, size - up to 4 cm;
The patient also suffers from insomnia, shortness of breath, and rapid heartbeat. The temperature rises with extensive inflammation, when the pathological process has already affected a large area of connective tissue.

Diagnostics

To clarify the type of disease, if the listed symptoms appear, you need to visit a neurologist, orthopedic traumatologist or vertebrologist. The doctor palpates the painful area, clarifies the clinical picture, and finds out whether there are chronic pathologies, including metabolic disorders and infectious diseases.

A set of diagnostic measures will be required:

biochemical blood test. It is important to identify nonspecific inflammation, find out the indicators of leukocytes, ESR, level of C-reactive protein;
a mandatory element of diagnosis is an x-ray of the thoracic spine;
provides accurate information about the condition of cartilage tissue.

Effective treatments

Complete cure of Tietze syndrome is possible only by removing the affected areas during surgery: many doctors believe so, but surgery is rarely prescribed, only in severe cases. With weak and moderate signs of inflammation, in most cases conservative measures are sufficient.

Note! If the pain syndrome due to costochondritis does not cause painful sensations to the patient, then doctors avoid surgery so as not to expose the patient to unnecessary risk. It is important to know: it is often after surgery that an infection penetrates into the vertebral structures. For this reason surgical treatment Doctors prescribe costochondritis as a last resort.

Medicines

The main groups of drugs for the treatment of perichondritis:

. Piroxicam, Ketoprofen, .
. Baralgin, Tempalgin.
Ointments, gels and creams. , Voltaren-emulgel, Finalgon, Comfrey ointment, Chondroxide, Nurofen, Dikul balm, natural cream-balm Sofia.
Compresses with Dimexide with anti-inflammatory, antimicrobial and local anesthetic effects.
(injections in combination with anesthetics) for severe pain. Hydrocortisone with Lidocaine, Flosterone, Diprospan, Betamethasone.

Physiotherapeutic procedures

For Tietze syndrome, the types of procedures are selected by the attending physician individually:

laser therapy;
darsonvalization;
UHF heating;
electrophoresis.

Go to this address and read about the typical symptoms and treatment options for a pinched nerve in the thoracic spine.

Folk remedies and recipes

Herbal decoctions, compresses, baths for Tietze syndrome are allowed as additional types impact on the problem area. You should always consult your doctor before starting any home treatment.

If the inflammatory process is active, the problem area should not be heated. Violation of the rule worsens the patient's condition, increases inflammation, pain, and swelling.

Note to patients:

useful herbal infusions to normalize blood circulation and strengthen the immune system. Herbalists recommend plants: St. John's wort, chamomile, juniper, nettle, sage, birch (leaves). Good effect gives the use of infusion of elderberry flowers, tea from lingonberry leaves;
Warm compresses to relieve pain from costochondritis. Procedures are carried out only when the inflammatory process subsides. Plants: horseradish (grate), sage (decoction), lemon balm and burdock leaves (steam in boiling water). After applying the compress, you need to wrap the problem area with a scarf. The heart area cannot be treated;
medicinal baths. A decoction of spruce branches and needles, chamomile flowers and sage. Do not warm up the heart area;
Rubbing an alcohol tincture has a good warming and analgesic effect in Tietze syndrome. From natural ingredients for cooking home remedy herbalists recommend healing eucalyptus ether and birch leaves;
Rendered bear and pork fat helps with severe pain. After applying the composition, you need to insulate the problem area. Just as when applying compresses, you need to avoid overheating in the heart area.

Surgical intervention

For costochondritis, doctors perform subperiosteal resection if non-surgical treatment methods have not shown noticeable results. Patients with Tietze syndrome are operated on extremely rarely. Depending on the severity of the case, the degree of damage to the ribs, the spread of the inflammatory process and the patient’s condition, surgical treatment is carried out under local or general anesthesia.

Possible complications

The progression of perichondritis often causes negative consequences:

calcification of cartilage tissue, the appearance of fibrous metaplasia;
replacement of connective tissue with bone disrupts the breathing process, deep breathing and coughing cause pain;
the more the cartilage tissue is affected, the higher the degree of calcification, the stronger the shortness of breath becomes, even after a low-fatigue walk;
dense swelling in the chest area interferes with the usual activities and causes discomfort during sleep.

When dull ache in the upper chest area, discomfort in the shoulder blade, arms, shoulder, if discomfort increases due to stress and movement, you need to visit an orthopedic traumatologist, neurologist or vertebrologist. The prognosis for Tietze syndrome is favorable if timely detection perichondritis. In advanced cases, with extensive inflammation in the cartilage tissue of the ribs, surgery will be required, which is always associated with risks.

Relevance. The variety and multiplicity of patient complaints, the similarity of the clinical picture of thoracic outlet syndrome with many other diseases, the relatively low frequency of this pathology in general structure morbidity often leads to diagnostic errors. Sick long time are observed by doctors of various specialties (neurologists, surgeons, orthopedists-traumatologists, therapists) with diagnoses: osteochondrosis cervical region spine, radiculitis, humeroscapular periarthritis, myositis, Raynaud's disease, etc., receive ineffective conservative treatment, which results in the development of severe, mainly vascular, complications.

Definition. Thoracic outlet syndrome (SOAHS) combines a group of symptoms that appear due to compression in the interscalene space of the nerves brachial plexus and subclavian vessels - arteries and veins (in the literature, SVAGK is also referred to as compression syndrome, scalene muscle syndrome, thoracic outlet syndrome, in foreign sources - thoracic outlet syndrome).

look(read) also the presentation “MRI technique of the brachial plexus. MRI semiotics of brachial plexus plexopathy" Khalikov A.D., Scandinavia Clinic (mrt.center) [read]

Etiology. Compression of the neurovascular bundle occurs as a result of:

Clinical phenomenology SVAGK. Based on the clinical picture, three types of SVAGK are distinguished (according to the specific structure of the neurovascular bundle:

The literature presents individual clinical observations of SVAHK, which are of interest as the rarest. For example, SVAGK combined with carpal tunnel and Guyon's canal syndromes, SVAGK with a fracture of the accessory cervical rib, SVAGK against the background of split costal arches on both sides (the so-called bifid ribs), formed by the fusion of the accessory cervical and first ribs. The observation of SVAGK in Poland syndrome and desmoid tumor in the area of the superior thoracic outlet is mentioned.

In children and adolescents, vascular forms predominate, while in almost 95% of adults, VAHS is neurological in nature. It is noted that typical for adult patients with n.SAHK are severe physical work, professional sports and injuries (whiplash while driving) in the anamnesis, which is not typical for children and largely explains the different course of the syndrome in these age groups. In addition, a number of authors believe that congenital anomalies skeletal problems are much more often caused by vascular compression and are more often diagnosed in childhood. In those adolescents who regularly play sports, the risk of developing SAGH increases. “Risk” sports from this point of view are weightlifting, baseball, volleyball, swimming (including synchronized swimming), and water polo. Despite the differences mentioned above in the prevalence clinical forms, the clinical picture of SVAHK in children and adults is similar.

Suspecting v.SVAGK allows the patient to experience swelling, cyanosis and pain in the upper limb during movement or at rest. Characteristic expansion of the superficial venous network of the upper limb and chest wall. Causes may include vigorous hyperabduction of the arm (for example, when playing catch) or lifting a large weight (strength sports), a fracture of the clavicle, or improper consolidation of the clavicle. In this case, at the junction of the first rib with the clavicle, compression of the subclavian vein occurs. Special case v.SVAGK is known as Paget-Schroetter syndrome, or “force thrombosis.”

If a.SVAGK is suspected, stress testing is mandatory. During the EAST (Elevated arm stress test), the patient spreads his arms to the sides and intensively clench and unclench his fingers. Positive result tests imply the occurrence of signs arterial insufficiency due to vessel compression. The test was introduced into practice by the American surgeon D. Roos and is better known as the Roos’ test. Another diagnostic test for patients with a.SVAGK is the Wright’s test (signs of arterial compression during hyperabduction of the upper limb). As for the well-known Adson’s test, it is considered less reliable than the first two, since it is positive in healthy people. The test is carried out by simultaneous palpation of the pulse on both radial arteries the patient takes a deep breath and turns his head in different sides, on the affected side the pulse disappears.

The most difficult to diagnose is n.SVAGK. It is generally accepted in the literature that today there is no instrumental study that would allow us to unambiguously confirm n.SVAGK. The surgeon has at his disposal nonspecific complaints from such patients: paresthesia, numbness of the upper limb, periodic or constant pain in the supraclavicular region with or without irradiation. IN rare sightings it is possible to identify a weakening of muscle tone and function of the arm muscles. In addition to routine radiography, CT and MRI of the cervical and thoracic areas, all patients with suspected neurogenic form undergo electroneuromyography (ENMG), in a number of cases somatosensory evoked potentials are determined and a diagnostic blockade of the scalene muscles is performed. As a rule, the results of these studies do not provide additional information. The information content of CT and MRI in case of n.SAHA does not exceed the information content of an x-ray, since other causes of nerve compression (besides the presence of skeletal abnormalities) cannot be identified. ENMG indicators, even with a pronounced clinical picture of n.SVAGK, do not go beyond the normal range. The study only helps to exclude other diseases peripheral nerves upper limb. In most observations of the neurogenic form of the syndrome in children, diagnosis is based on subjective complaints and anamnesis data, and instrumental studies allow us to confirm the diagnosis of n.SVAGK by the “method of excluding” others possible diseases. In the list of main diseases for differential diagnosis osteochondrosis and intervertebral hernias of the cervical and thoracic spine, carpal tunnel syndrome, cubital syndrome, “swimmer’s shoulder”, myofascial pain syndrome, and psychosomatic diseases are present. The literature describes a large number of observations in which, in children with n.SVAGK, even after a comprehensive examination, no morphological reasons for their complaints were identified. In adult patients with unclear clinical picture and impossibility accurate diagnosis An additional form of the syndrome is identified - the so-called unconfirmed neurogenic disputed TOS. They try to treat such patients conservatively, usually without success. Surgical treatment full recovery also does not guarantee. Surgeries are considered “exploratory”, and patients are prepared for the possibility of an unsatisfactory outcome in advance.

Principles of therapy. Conservative treatment SVAGK raises many questions. It is used mainly for the neurogenic form and often without effect. Selective operations (scalenotomy, scalenectomy, isolated excision of skeletal anomalies, accessory and hypertrophied ribs, muscles and ligaments) are still used, despite the obvious unreliability. The latter is due to the fact that a number of anatomical causes can only be identified intraoperatively (especially abnormal muscles and ligaments), but even operating table this is extremely difficult, since the surgeon works in a narrow and almost “blind” space. Inadequate volume of surgery causes a high percentage of relapses with minimal interventions. The choice of surgical approach based on the clinical and anatomical picture in a particular patient includes possible use transaxillary (most common), supraclavicular and paraclavicular approaches. For effective decompression of the upper thoracic outlet, it is necessary to perform resection of the first rib (segmental or complete) with the removal of existing skeletal anomalies; selective operations are fraught with relapses of SIAH. Given the small samples of patients, it is impossible to objectively assess the results of treatment. For prevention adhesive process In the area of surgery, it is recommended to begin rehabilitation from the 1st postoperative day. An effective alternative to traditional operations (in adults) are endoscopic operations, as well as operations using the daVinci robotic surgical system through transaxillary access. The latest methods improve the quality of the operation and reduce the number of intra- and postoperative complications (injury of the subclavian vessels and damage to the brachial plexus during traction of the patient’s upper limb).

Read also:

article“Superior thoracic outlet syndrome - clinical and diagnostic features” A.F. Murtazina, S.S. Nikitin, E.S. Naumova; Medical center“Practical Neurology”, Moscow (magazine “Neuromuscular Diseases” No. 4, 2017) [read];

clinical protocol “Diagnostics and treatment of thoracic outlet syndrome” is recommended by the Expert Council of the Republican State Enterprise at the Republican Center for Healthcare Development of the Ministry of Health and social development Republic of Kazakhstan dated November 30, 2015, protocol No. 18 [read];

article “Clinical and diagnostic features in the surgical treatment of superior thoracic outlet syndrome” R. Muin, R.K. Magomedov, I.I. Tsuladze; Department of Neurosurgery of the Russian medical academy postgraduate education, Moscow (magazine “Questions of Neurosurgery” No. 2, 2015) [read];

article “Thoracic outlet syndrome” by V.A. Prasol, E.V. Mishenina, A.V. Chinilin, I.A. Taraban; State Institution “Institute of General and Emergency Surgery named after. V. T. Zaitseva NAMNU”, Kharkov (magazine “Kharkov Surgical School” No. 2, 2014) [read];

article “Surgical aspects of thoracic outlet syndrome in children and adolescents” by A.Yu. Razumovsky, V.E. Rachkov, E.V. Ekimovskaya; Department of Pediatric Surgery of the Russian State medical university, children's city clinical hospital No. 13 named after N.F. Filatova, Moscow (magazine “Surgery” No. 7, 2011) [read];

article “Diagnostics and treatment of thoracic outlet syndrome” by N.S. Abyshov, A.M. Mamedov; research institute clinical medicine them. acad. M. Topchibasheva, Baku, Azerbaijan (magazine “Surgery” No. 6, 2007) [read];

article “Thoracic outlet syndrome: anatomy, symptoms, diagnosis and surgical treatment” by Professor, Doctor of Medical Sciences Povilas Pauliukas [read];

SVAGK in foreign sources:

Helical CT Angiography of Thoracic Outlet Syndrome Functional Anatomy [read].

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Causes of Tietze syndrome

The German surgeon Tietze, after whose name the anterior chest wall syndrome was named, considered its main cause to be insufficient nutrition, which leads to metabolic disorders (for example, hypovitaminosis or calcium metabolism). In his opinion, the disease can also be provoked by frequent illnesses upper respiratory tract, accompanied severe attacks cough.

In fact, the exact causes of Tietze syndrome have not been established to this day, since costochondritis is considered a rare pathology. At the same time, it is possible to identify several factors that actively contribute to the emergence and development of of this disease:

Regular physical activity on the upper shoulder girdle;
Constant physical activity on the chest;
Periodic microtraumas of the chest, for example, bruises when practicing certain combat sports;
Respiratory diseases;
Past infectious diseases;
Allergy;
Autoimmune diseases;
Collagenosis;
Arthritis;
Arthrosis.

We can say that the cause of Tietze syndrome is often any disease, disruptive metabolism in connective tissues and reducing the immunological properties of the human body.

Since blood circulation in the cartilage tissue is impaired after surgery and it is more susceptible to infection, Tietze syndrome can also be caused by surgery in the chest area.

Symptoms of Tietze syndrome

Tietze syndrome does not have pronounced symptoms, so it is usually very difficult to determine: doctors often make mistakes with the diagnosis. However, some basic symptoms of Tietze syndrome can be mentioned:

Acute attacks of pain in the front of the chest;
Movement of pain down or into left area sternum;
The center of pain is usually the fourth, fifth and sixth ribs;
With any movement of the body, the pain worsens;
At deep breathing pain also intensifies and, conversely, at rest and with light breathing, it recedes;
When you press your fingers into the area where the ribs attach to the sternum, noticeable pain is observed.

It should be noted that the last symptom of Tietze syndrome on the list is the most common sign of the disease. If no pain is felt during palpation in the area of the junction of the chest and ribs, the likelihood of having this disease is extremely low.

Another characteristic symptom of Tietze syndrome is a slight swelling in the area of the affected costal cartilage. As a rule, its size is 3-4 cm and it has a dense surface. Any touch to this area causes pain in a person. If a patient has one of these main signs, the development of Tietze syndrome can be assumed.

In some patients, the above symptoms of costochondritis are accompanied by shortness of breath, decreased appetite, insomnia and tachycardia. Rarely additional symptoms Tietze syndrome is characterized by swelling of the skin in the chest area and a local increase in temperature.

X-rays are practically meaningless when diagnosing this disease, since early stages does not reveal the occurrence of costochondritis. It is necessary only in order to exclude the presence of lung diseases or all kinds of diseases during the examination. oncological diseases. To determine Tietze syndrome, it is recommended to undergo computed tomography, which is able to recognize changes characteristic of the disease in the early stages.

Treatment of Tietze syndrome

Many experts agree that complete treatment of Tietze syndrome is possible only with the help of surgical intervention. But subperiosteal resection, which is performed in such situations, is considered an extreme case, since costochondritis often does not bother patients much, even for decades. Some of them do not even suspect the existence of Tietze syndrome, since no characteristic symptoms are observed.

That is why treatment of Tietze syndrome, as a rule, comes down to the use of the most common conservative methods:

Local therapy using various ointments and gels that have an anti-inflammatory effect;
Compresses with dimexide;
Physiotherapeutic treatment and reflexology;
Novocaine blockade of intercostal nerves;
Injections of an anesthetic with a steroid into the area where the pain is located;
Nonsteroidal anti-inflammatory drugs and analgesics.

Treatment of Tietze syndrome with similar methods, naturally, will not help eliminate fibrocystic formation. However, these drugs help reduce swelling and inflammation, and also alleviate pain. On the other hand, Tietze syndrome is considered chronic disease, which, even if it disappears for a while, still returns. Thus, side effects may occur from the constant use of anti-inflammatory and painkillers.

Treatment of Tietze syndrome with folk remedies

Some recipes may also help with costochondritis traditional medicine. Main folk remedies Treatments for Tietze syndrome are:

Therapeutic baths;
Decoctions;
Compresses;
Rubbing.

For medicinal bath you need to pour 300 g pharmaceutical chamomile 5 liters of boiling water, leave for an hour and strain. Pour the broth into a bath of warm water. It is recommended to take such a bath for 20 minutes every other day. Instead of chamomile, sage and fresh spruce branches are also used.

Treatment of Tietze syndrome with folk remedies using decoctions is aimed primarily at improving blood circulation and increasing immunity. As a rule, the following are used for decoctions: medicinal components How:

St. John's wort;
Sage;
Thyme;
Yarrow;
Juniper fruits;
Nettle roots.

Compresses for Tietze syndrome are made from a decoction of rosemary, steamed lemon balm leaves or horseradish. A shawl or warm cloth should be tied over the applied compress.

Rubbing the chest with bear or pork fat also helps. Often in inflamed areas rubbed in alcohol tinctures from eucalyptus and birch buds. After the procedure, you need to cover yourself with a warm blanket to prolong the warming effect.

However, it should be remembered that before practicing treatment of Tietze syndrome with folk remedies, you must consult a doctor.