In addition, ultrasound can diagnose Tietze syndrome, whereas costochondritis relies heavily on physical examination and medical history.Another condition that can be confused for Tietze syndrome and costochondritis is slipping rib syndrome (SRS). All three conditions are associated with chest pain as well as inflammation of the costal cartilage. Unlike both costochondritis and Tietze syndrome, which affect some of the true ribs (1st to 7th), SRS affects the false ribs (8th to 10th). SRS is characterized by the partial dislocation, or subluxation, of the joints between the costal cartilages. This causes inflammation, irritated intercostal nerves, and straining of the intercostal muscles. SRS can cause abdominal and back pain, which costochondritis does not. Tietze syndrome and SRS can both present with radiating pain to the shoulder and arm, and both conditions can be diagnosed with ultrasound, though SRS requires a more complex dynamic ultrasound.The vast differential diagnosis also includes:

Pleural diseases including pleurisy, pneumonia, pulmonary embolism, and pneumothorax. Rheumatic disorders such as rheumatoid arthritis, ankylosing spondylitis, and rheumatic fever. Arthritis of the costal cartilages, including rheumatoid arthritis, septic arthritis (pyogenic), monoarthritis, and psoriatic arthritis. Neoplasms, both benign and malignant (cancerous), including chondroma, osteochondroma, multiple myeloma, osteosarcoma, Hodgkin lymphoma, and carcinoma. Nerve pain, specifically intercostal neuritis and intercostal neuropathy. Aortic dissection, a serious condition involving a tear in the bodys largest artery. Treatment
Tietze syndrome is considered to be a self-limiting condition that usually resolves within a few months with rest.
Syringobulbia is a medical condition in which syrinxes, or fluid-filled cavities, affect the brainstem (usually the lower brainstem). The exact cause is often unknown, but may be linked to a widening of the central canal of the spinal cord. This may affect one or more cranial nerves, resulting in various kinds of facial palsies. Sensory and motor nerve pathways may be affected by interruption or compression of nerves. This disorder is associated with syringomyelia, a syrinx limited to the spinal cord. It can be diagnosed using magnetic resonance imaging. Symptoms may be treated with tricyclic antidepressants. Signs and symptoms
Syringobulbia usually causes pain. It may also cause a loss of sense of temperature. Alveolar hypoventilation (insufficient breathing, a type of central hypoventilation syndrome) may occur, with hypercapnia (excess blood CO2), stridor (an unusual breathing sound), and irregular breathing. Cause
Syringobulbia may be caused by a birth defect, trauma or tumor growth. The exact trigger is unknown, but may be linked to a widening of the central canal of the spinal cord. Mechanism
Syringobulbia affects the lower part of the brainstem. The central canal of the spinal cord may be widened. A fluid-filled lesion forms, known as a syrinx. This can vary in size significantly between patients. Nerve fibres may be compressed where they cross the midline, or in other parts of the spinal cord. Cranial nerves may be affected.Syringobulbia may be associated with syringomyelia, a syrinx limited to the spinal cord. Diagnosis
Syringobulbia may be diagnosed using magnetic resonance imaging.