Chest pain is commonly caused by musculoskeletal chest wall disorder. Tietze's syndrome is a relatively rare cause of chest wall pain. It is a benign, self-limited, non-specific inflammatory disease of the upper costochondral junction. Although trauma and infection have been implicated, the etiology remains to be clarified. The presenting symptoms include local tenderness, swelling and occasional pain. The second ribs are the most commonly involved. The diagnosis is based on the typical local swelling and tenderness, with normal radiograph. The ultrasonographic examination is the screening procedure of choice for Tietze's syndrome. Tietze's syndrome usually responds well to infiltration with steroid into the painful junction. Septic arthritis of the sternoclavicular joint is an uncommon condition, and the diagnosis can be missed until a complication occurs. We report two patients who were diagnosed with Tietze's syndrome and one patient with septic arthritis mimicking Tietze's syndrome. (J Korean Assoc Pain Med 2005; 4:94-99)

KeywordsAnterior chest wall pain, Tietze's syndrome, Septic arthritis