Tietze's syndrome1 is an entity manifested by painful nonsuppurative swelling of the costal cartilages. The second costal cartilage is most frequently involved. The disease has been reported in both sexes between the ages of 13 and 60 years. The majority of cases occurred in young adults. Chest pain at the involved site gradually develops until a firm, smooth, visible mass, protruding 0.5 to 3 cm. above the chest wall, becomes palpable. Tenderness directly over the involved costal cartilage is extreme at the onset but usually disappears within a few weeks, while the swelling often remains for months or even years. At the peak of the disease, the patient complains bitterly of local pain that is made worse by sneezing, coughing, or bending. The skin over the swelling is freely mobile and not inflamed. There is no regional lymphadenopathy. Respiratory infections frequently precede and accompany Tietze's syndrome. Roentgenograms of the