MRI findings of Tietze's syndrome mimicking mediastinal malignancy on MDCT

Abstract

Tietze's syndrome is a relatively rare disorder, characterized by non-suppurative inflammation affecting the costo-sternal and sterno-clavicular joints. We describe the case of a patient affected by Tietze's syndrome clinically presenting with sudden onset of chest pain, initially diagnosed as anterior mediastinal malignancy on multidetector computer tomography. In order to characterize the nature of the lesion, we performed an open biopsy that disclosed no malignant cells. The patient was treated with non-steroidal anti-inflammatory drugs and local intramuscular injections; a progressive decrease of the mass was observed. MRI of the anterior thoracic wall disclosed spongious edema of the left sterno-clavicular joint, cortex preserved and soft-tissue edematous thickening. These findings were consistent with Tietze's syndrome.