largest artery. Treatment Tietze syndrome is considered to be a self-limiting condition that usually resolves within a few months with rest. Management for Tietze syndrome usually consists of analgesics and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, aspirin, acetaminophen (paracetamol), and naproxen. Other methods of management include manual therapy and local heat application. These are intended to relieve pain and are not expected to treat or cure Tietze syndrome as the condition is expected to resolve on its own. Intercostal nerve block A nerve block can be utilized in cases where symptom management is not satisfactory in relieving pain. This is usually a nerve-blocking injection that consists of a combination of steroids such as hydrocortisone, and anesthetics such as lidocaine and procaine, which is typically administered under ultrasound guidance. One study used a combination of triamcinolone hexacetonide and 2% lidocaine in 9 patients and after a week, found an average 82% decrease in size of the affected costal cartilage when assessing with ultrasound as well as a significant improvement of symptoms clinically. However, the long-term effectiveness of the injection is disputed, with multiple researchers describing recurrence of symptoms and repetitive injections. Surgical intervention In refractory cases of Tietze syndrome, where the condition is resistant to other conservative treatment options, surgery is considered. Surgery is uncommon for cases of Tietze syndrome, as many describe Tietze syndrome as manageable under less invasive options. The use of surgery in this context refers to the resection of the affected costal cartilages and some of the surrounding areas. Some surgeons have resected cartilage matching the symptoms of Tietze syndrome under the assumption the cartilage was tubercular. One study describes a case in which surgeons resected a large amount of cartilage, including minutely hypertrophied tissue, as a previous resection failed to relieve symptoms which is believed to be due to improperly resected margins. There is limited literature on surgical treatment of this disease, and overall research on the treatment of severe, chronic forms of Tietze syndrome. History Tietze syndrome was named after and first described in 1921 by German surgeon Alexander Tietze. Tietze first cited 4 cases in Germany of painful swelling where he originally believed the condition was as a result of tuberculosis or wartime malnutrition. References External links Syndromes with musculoskeletal abnormalities Musculoskeletal disorders