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Ultrasound-Guided Corticosteroid Injection in a Patient With Tietze Syndrome Combined With Costochondral Joint Swelling

Cho, Ju Young MD; Park, Donghwi MD

American Journal of Physical Medicine & Rehabilitation: July 2019 - Volume 98 - Issue 7 - p e71–e73
doi: 10.1097/PHM.0000000000001072
Case Report

Tietze syndrome is an uncommon disease of unknown etiology that manifests as pain and tenderness of the parasternal joints. To date, however, there has been no report on ultrasonographic findings concerning swelling of the costochondral joint in Tietze syndrome. Moreover, there has been no research investigating images of ultrasound-guided corticosteroid injection, although corticosteroid injection is one of the most important treatments for Tietze syndrome. Therefore, we report a case of Tietze syndrome where ultrasound images were used in the diagnostic and therapeutic process. A 70-yr-old man was seen for left chest pain that had lasted for several weeks. Physical examination at our clinic revealed a focal tenderness of the left third costochondral joint, and an ultrasound showed a swelling of the left third costochondral joint. Considering both the radiological and the clinical examination, the patient received a diagnosis of Tietze syndrome with costochondral joint swelling. Then, the patient agreed to an ultrasound-guided left third costochondral corticosteroid injection after receiving a detailed explanation of the disease and treatment. After receiving three ultrasound-guided corticosteroid injections, his chest pain subsided, and the swelling and tenderness also disappeared completely. Collectively, our case suggests that ultrasound is important in the diagnosis and treatment of Tietze syndrome.

From the Department of Rehabilitation Medicine, Daegu Fatima Hospital, Daegu, South Korea.

All correspondence should be addressed to: Donghwi Park, MD, Department of Rehabilitation Medicine, Daegu Fatima Hospital, Ayangro 99, Dong gu, Daegu 41199, Republic of Korea.

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning (NRF- 2017R1D1A1B03033127).

No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.

Ju Young Cho is in training.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

Online date: October 23, 2018

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