ULTRASONOGRAPHIC ASSESSMENT OF LOCAL STEROID INJECTION IN TIETZES-SYNDROME

The purpose of this study was to investigate the value of ultrasonogra phic examination in the diagnosis of Tietze's syndrome and assessment of the changes in costal cartilage following local steroid injection. Nine patients with Tietze's syndrome and 20 normal subjects were studi ed consecutively. Ultrasound examination was performed using a Sonolin e SL Siemens Machine with a linear 5 MHz small parts transducer and AT L Apogee 800 with a 10 MHz linear array transducer. The affected costo chondral joint was injected with a combination of 15 mg of triamcinolo ne hexacetonide and 1 ml of 2% lidocaine. Ultrasound examination was p erformed following the clinical evaluation and repeated immediately af ter the injection, then 1 and 4 weeks later. Abnormal echo appearance was detected as an inhomogeneous increase in the echogenicity with int ense broad posterior acoustic shadow. Hypoechogenicity and a decrease in the size of costal cartilage were observed 1 week after local stero id injection with absence of the posterior acoustic shadowing. Ultraso nographic examination of costal cartilage is easy and quick to perform . We believe that ultrasound should be the screening procedure of choi ce for Tietze's syndrome. Local steroid injection proved to be clinica lly safe and effective in the treatment of patients with Tietze's synd rome.