Sternocostal joint swelling--clinical Tietze's syndrome. Report of sixteen cases and review of the literature.

Sixteen patients with painful tender swelling in the region of the sternocostal joint (SCJ) are reported and analysed against the background of a review of 106 previously reported patients with Tietze's syndrome. Seven patients fulfilled all the diagnostic criteria for Tietze's syndrome. The radiographic findings and/or the history of these patients suggested that local strain generated by respiration is a pathogenetic factor. Nine patients had a systemic arthritic disorder, skin disease, or psoriasis in their family. They differed from the 7 patients with local involvement and from those reviewed, by the rather frequent bilateral involvement, a frequent affection of the first SCJ and the manubriosternal joint, and a female predominance. Their SCJ swellings may be viewed as part of a seronegative arthritis.