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At least 19 recordsLinked to original sources
PubMed1994

[Degenerative chondroarthropathy of the sternocostal joint following heart surgery].

Involvement of the sternocostal joints was investigated in a series of 46 males and 18 females following median sternotomy annually in a 5-year period and compared to 62 age- and sex matched control subjects after one year solely. Both groups had a mean age of 49.2 years. The degenerative chondroarthropathy of sternocostal joints was 1.69-times more frequent in heart operated upon patients as compared to control persons. Based on radiographic findings the degenerative chondroarthropathies were classed in 0 to 3 severity groups. Were seen articular space narrowing in 95.4%, osteophytes of the margin of the articular surface in 88%, subchondral bony eburnation in 79% and cystic radiolucencies in 48.9% of sternocostal joints on poststernotomy standard plain film tomograms. Not occurred intraarticular gas phenomenon and bony ankylosis. The development of arthropathies is traced back to mechanical stress-related predisposing factors and stressed the importance of oculoneutral dehiscences that simulated normal roentgenanatomic projections and caused a masked insufficiency in sternocostal junctions.

Adult↗
PubMed1989

Sternocostal joints. Anatomic, radiographic and pathologic features in adult cadavers.

Using radiographic-pathologic correlation, we studied the sternocostal joints derived from 27 consecutive cadavers and one additional cadaver with rheumatoid arthritis. Radiographic findings that were tabulated included joint space narrowing, sternal or costal osteophytes, articular calcification, vacuum phenomena, and the degree of ossification of the costal cartilages. The first sternocostal joint could be classified as either a synchondrosis or synostosis in every instance; however, a joint cavity lateral to the first sternocostal joint represented a normal variation and was seen radiographically in 10 specimens. The second sternocostal joint was synovial in type and intimately related to the manubriosternal joint; cavitation within this joint was present bilaterally in 36% of our specimens. Degenerative changes in the sternocostal articulations were characterized much more frequently by sternal osteophytes than by costal osteophytes or joint space narrowing. Calcification compatible with chondrocalcinosis was observed in two cadavers. Radiographic and pathologic evidence of synovial inflammation was evident in the sternocostal joints of the rheumatoid specimen.

Aged↗
PubMed1988

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.

Arthritis↗
PubMed1988

Sternocostal joints, low back pain and lumbar discopathy.

New interrelations between the distensions of the 5th, 6th and 7th ribs and low back pain were studied in two groups of patients: 1) one hundred out-patients with prevalent pseudoradicular symptomatology and 2) fifty patients hospitalised for graphically verified (CT, PMG) lumbar disc herniation and pronounced radicular symptomatology. We have introduced some measurements to document asymmetrical holding of the body and limbs: the distance between the sternoclavicular joint-spina iliaca ant. sup. and the distance between the acromion and spina iliaca post. sup. We found that in the distension (blockade) of the 5th rib, constant spasms are present in m. abdominis obliquus ext., in the most lateral part of the adductors and in the most medial part of the great gluteal muscle. In 6th rib distension, spasms in the external part of the m. rectus abdominis, and in the mediolateral fascicles of thigh adductors and in the external part of m. glutaeus max. could be palpated. In 7th sternocostal distension there are spasms in the most medial parts of m. rectus abdominis, and of thigh adductors and m. glutaeus medius of the same side. After mobilization, statistically significant improvement of body asymmetry (p less than 0.01), improvement of anteflection, bending to the side, Laségue's and Patric's phenomena were found. Surgery was indispensable only in 6% of our patients suffering from severe lumbar disc hernianion (in 3 out of 50). The CT appearance of the prolapse remained unaltered even after clinical remission. There were some changes before and after mobilization in the CT picture of sternocostal joints. The importance of strengthening of the great pectoral muscles--in which preexistent relative weakness was found--is stressed. The beneficial effect of mobilization of the respective sternocostal blockade on the pain syndrome, body asymmetry and mobility is described.

Adolescent↗
PubMed1988

Palmoplantar pustulosis and sternocostoclavicular arthro-osteitis.

Seventeen patients with shoulder pain and radiographic involvement of the sternoclavicular or sternocostal joints, or both, are described. Eleven of these patients also had palmoplantar pustulosis. Histological examination of the joints showed chronic and subacute inflammation, increased osteoblastic activity, and cartilage degeneration. Propionibacterium acnes was cultured in tissue samples from seven of the 15 biopsied patients, a finding at variance with those of previous reports. The possibility that sternoclavicular arthro-osteitis is of infectious origin should be the subject of further investigation. Non-steroidal anti-inflammatory drugs (NSAIDs) may provide pain relief, possibly owing to their inhibitory action on osteoblasts. In cases of severely restricted movement or severe pain resection of the medial clavicle may be considered.

Adult↗
PubMed1991

Seronegative arthritides of the anterior chest wall: a follow-up study.

Fourteen patients with arthritis of the anterior chest wall (ACW) as part of ankylosing spondylitis, reactive arthritis, and arthritis associated with psoriasis and/or pustulosis palmoplantaris (PPP) were re-examined after periods of 5-15 years (mean 9 years) using tomography. The findings were compared with those of 24 similarly examined patients with predominant osseous sclerotic ACW lesions or monarthritis of the manubriosternal joint. Pronounced osseous hyperostosis in the region of the sternoclavicular joint accompanied by ossification of the costoclavicular ligament was found to occur only in patients with PPP lesions. Patients with ankylosing spondylitis and reactive arthritis developed slight or moderate hyperostosis only and no ligament ossification. Predominant osseous sclerotic sternal and clavicular lesions occurred in patients with PPP and in patients without skin disease or traits suggesting well-known arthritides, but not as part of ankylosing spondylitis and reactive arthritis. Arthritis of the manubriosternal joint and upper sternocostal joints developed in all forms of arthritis.

Adolescent↗
PubMed1993

Osteoarticular infection in intravenous drug abusers: influence of HIV infection and differences with non drug abusers.

OBJECTIVES: To determine (a) the influence of HIV in developing osteoarticular infections in intravenous drug abusers (IVDAs) and (b) the differences between the clinical features of osteoarticular infections in IVDAs and a control group of non-IVDAs. METHODS: A comparative study of the clinical features of osteoarticular infections in all HIV positive and HIV negative IVDAs admitted to the departments of rheumatology and internal medicine during a 10 year period was carried out. The joint infections of all IVDAs, irrespective of HIV status, were compared with those of a control group of non-IVDAs lacking risk factors for HIV infection. RESULTS: A total of 482 HIV positive and 85 HIV negative IVDAs was studied, in whom 25 (5%) and six (7%) osteoarticular infections were found respectively. There were no differences in age, sex, joints affected, and causative agents between these two groups. A comparison of the 31 (5.5%) osteoarticular infections in all IVDAs with 21 infections in 616 (3.4%) non-IVDAs showed significant differences in the mean age (27.5 v 54), the frequency of affection of the axial joints (hip, sacroiliac, and sternocostal joints) (64.5% v 16.6%), and in the incidence of Candida albicans (19% v 0%). CONCLUSIONS: (1) HIV may not predispose to osteoarticular infections in IVDAs. (2) The hip, sacroiliac, and sternocostal joints (axial joints) were most commonly affected in IVDAs. (3) In Spain, unlike other countries, Gram positive bacteria and C albicans seem to be predominant agents in osteoarticular infections in IVDAs, with a low incidence of Gram negative bacteria.

Adolescent↗
PubMed1998

Four cases of pustulotic arthro-osteitis.

We describe four cases of pustulotic arthro-osteitis. All of them suffered from anterior chest wall symptoms, such as swelling and pain on the sternoclavicular joint, sternal angle area, sternocostal joint, and costochondral junction. Although chest X-ray findings were all normal, 99mTc-scintigraphy revealed increased uptake in the affected areas in all cases. Laboratory examinations including rheumatoid factor were negative or normal except for elevation of the erythrocyte sedimentation rate and C-reactive protein in 2 cases. After treatment with non-steroidal anti-inflammatory drugs and etretinate or topical PUVA, the skin lesions on the palms and soles and the arthro-osteitis were moderately improved. Pustulotic arthro-osteitis should be considered when a patient with pustulosis palmoplantaris complains of anterior chest wall pain and other joint pain.

Adult↗
PubMed1985

[Anterior thoracic and intervertebral erosive joint diseases associated with palmoplantar pustulosis].

The authors report three cases of palmo-plantar pustulosis associated with articular signs: erosive arthritis of the right first sternocostal joint in 2 cases (without hypertrophy of the clavicle or the sternum) and atlanto-occipital arthropathy with marked neck stiffness in another case. The HLA phenotype of one case was: A2 - A9 - B14 - X - DR3 - DR4. A surgical sterno-costal biopsy revealed non-specific inflammatory lesions in 2 cases. In one of these cases, a Corynebacterium sp. was isolated. The clinical course was favourable in response to local antibiotic therapy in one case (follow-up of 8 years) and after treatment with non-steroidal anti-inflammatory agents in 2 cases (follow-up of one to two years). The skin biopsy revealed non-spongiform (and therefore non-psoriatic) unilocular pustulosis, distinguishing this non-bacterial pustulosis from pustular palmo-plantar psoriasis with which it is frequently confused. These cases are similar to the cases of "pustulotic arthro-osteitis" reported by Japanese authors (Sonozaki et al.), which appear to be rare in Europe. They seem to be an early form in a vast range of spondylo-arthropathies including rheumatism and acne conglobata. The aetio-pathogenesis of this syndrome is discussed; one of the cases is strongly suggestive of an infectious origin (Corynebacterium). These lesions do not appear to be a form of reactive arthritis, as the presence of HLA B27 is rare in both the European and the Japanese cases.

Adult↗
PubMed1987

Radiographic findings in patients with clinical Tietze syndrome.

Thirteen patients with similar painful tender swelling in the region of the sternocostal joint (SCJ) are reported. X-ray tomography revealed changes which might explain the swelling in 11 patients. Three patients had anatomical variants of the sternum. One of these and a further two patients had marginal osteophytes at the affected SCJ, as signs of osteoarthrosis. Six patients with psoriasis, pustulosis palmoplantaris, or psoriasis in the family had past or present arthritis of the involved SCJ or the manubriosternal joint. Tomography was found to be a useful confirmatory examination in patients with clinical Tietze syndrome.

Adult↗
PubMed1993

The acquired hyperostosis syndrome: a little known skeletal disorder with distinctive radiological and clinical features.

The acquired hyperostosis syndrome (AHS) is a chronic inflammatory disorder of bone of unknown etiology. It is accompanied by circumscribed hyperostosis which can be associated with ossifying lesions at sites of tendinous and ligamentary insertions and erosive or non-erosive arthritis. The predominant location of lesions is the sternocostoclavicular region (approximately 80% of patients), less frequent are involvement of the spine, pelvis, and appendicular skeleton. In 20%-60% of cases AHS is associated with palmoplantar pustulosis, psoriasis, or severe acne (acne fulminans or conglobata). The X-ray appearance of AHS is a more or less homogeneous increase in density with blurred margins, which on scintiscan with labeled phosphate compounds is associated with intense accretion of tracer. These features are associated with a variable increase in the acute phase reactants and a conspicuously low increase, if any, in serum alkaline phosphatase. The therapeutic modalities which have been used so far are entirely symptomatic. Long-lasting improvement has been reported following percutaneous anti-inflammatory radiation therapy.

Acne Vulgaris↗
PubMed1989

Computed tomographic appearances of sternocostoclavicular hyperostosis.

Computed tomographical analysis of sternocostoclavicular hyperostosis was performed in 27 patients. In the earliest stage hyperostosis occurred around the cartilaginous portion of the first ribs. The sternoclavicular joint space was preserved even in the late stage III of the disorder. These findings suggest that sternocostoclavicular hyperostosis develops around the costal cartilage including periosteum, perichondrium, and the ligamentous structures, and that the sternoclavicular joint is not primarily involved. It is also suggested that perichondritis and periostitis play important roles in the etiology of this disorder.

Adult↗
PubMed1979

Clinical features of 22 cases with "inter-sterno-costo-clavicular ossification". A new rheumatic syndrome.

We present 22 cases with inter-sterno-costoclavicular ossification. Clinical and pathological findings show that abnormal ossification observed in this situation is due to non-suppurative chronic inflammation of the soft tissues around the sterno-costo-clavicular region such as the costo-clavicular ligament. We have classified X-ray findings into three stages according to the extent of the ossification; localized, generalized, and hyperostotic, and show that the disease progressed in this sequence. A considerable number of the patients showed abnormal X-ray findings in the spine or the sacro-iliac joint. Frequent association of pustulosis palmaris et plantaris was noted in this disease. Most of the cases were treated effectively with anti-inflammatory drugs, but a few cases required surgical resection of the ossified mass with the clavicle or the first rib in order to relieve the severe pain.

Adult↗
PubMed1991

Arthropathy associated with palmoplantar pustulosis.

A survey of 170 patients with a diagnosis of palmoplantar pustulosis (PPP) has been undertaken. Detailed family histories of our patients were compiled, dermatological and rheumatological examinations were made. Radiography was performed in patients with clinical suspicions of spinal and/or sacroiliacal, sternoclavicular and sternocostal joint involvement. Active chest-wall symptoms were screened by scintigraphy. Twenty-five patients (16 females, 9 males, with an age range of 32-66, mean 51 years) had some rheumatic complaints. Fifteen of them (60%) had anterior chest-wall involvement, 6 (24%) sacroiliitis (3 of whom also had AS) and 11 (44%) peripheral arthropathy. Six other patients suffered from transient and migratory joint pain. The joint disease was mild in all but 6 cases. Laboratory tests showed increased ESR in 6 patients (24%); only 3 of these patients had elevated CRP. A slightly elevated haptoglobin and/or orosomucoid were found in 12 cases (48%). Elevated IgA was present in 4, IgG in 2 and IgM in 1 patient. Fungal and bacteriological cultures of the skin were negative. A family history of psoriasis was present in 4 patients (16%), of psoriatic arthropathy in 1 patients (4%) and of PPP in 2 patients (8%). Six patients (24%) had concomitant psoriasis. No association between PPP H1a-AC antigens was found. A high incidence of HLA-B27 antigen, present in 8 patients (32%), was documented. A similar association with HLA-B27 has been found in patients with psoriatic arthritis (16). The feeble association with HLA-B13,-17,-37 and CW6 found in psoriasis was not present.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Acquired hyperostosis syndrome: spectrum of manifestations at the sternocostoclavicular region. Radiologic evaluation of 34 cases.

Thirty-four patients with chest wall hyperostosis, a condition which has been designated by various terms in the literature were evaluated radiologically. We prefer the name acquired hyperostosis syndrome (AHS), which we categorize into the complete, incomplete and possible form. In complete AHS, sternocostoclavicular hyperostosis is associated with axial and/or peripheral (endosteal, periosteal, enthesopathic, metaplastic) hyperostosis and with psoriasiform or acneform dermatosis. In addition, these three manifestations are accompanied by erosive or non-erosive peripheral and/or axial arthritis to a variable degree. Sometimes, concomitant findings which are consistent with ankylosing spondylitis are also to be found in the axial skeleton. AHS is manifested at 11 different sites on the anterior chest wall. Ossification forms of the costal cartilage, inflammatory enthesopathies (three different insertions) and focal hyperostoses as well as processes of remodelling of the ribs, clavicles and sternum which are described in detail have particular diagnostic significance. AHS can start simultaneously at one, two or several sites on the anterior chest wall. Conventional tomography (possibly supplemented by CT) is necessary for early diagnosis and for analysis of the various findings on the anterior chest wall.

Adult↗
PubMed1997

Acquired hyperostosis syndrome--AHYS--(sternocostoclavicular hyperostosis, pustulotic arthro-osteitis, SAPHO-syndrome): bone scintigraphy of the anterior chest wall.

The objective of this report is to provide a description of diagnostically significant scintigraphically recognizable sites and patterns of acquired hyperostosis syndrome (AHYS) on the anterior chest wall (ACW), which is involved in 82% of AHYS patients. In 49/90 of our own AHYS patients, planar bone scans of the ACW were performed with the gamma camera, applying an average of 650 MBq of 99mTc-phosphate complexes. In addition, 53 atraumatic patients with extrathoracic cancer were available for routine whole-body scintigraphy. None of these patients had increased uptake identifiable as metastasis clinically or by imaging modalities in either the ACW or the rest of the skeleton. The scintigraphic involvement of the various morphological ACW structures is described in AHYS. Moreover, attention is called to the diagnostic significance of focal hyperactivities at the anterior end of the 2nd-8th rib of adults, which are in the 5th place with respect to their frequency in AHYS. The diagnostic significance of sternocostal-joint involvement in AHYS can likewise be recognized by bone-scan scintigraphy and will be discussed. Bone scintigraphy is more sensitive than radiomorphological imaging in AHYS. This, however, only applies under three conditions. 1. The increased radiotracer uptake in the upper sternocostoclavicular region must be assessed on both the anterior and the posterior view of the ACW scan. 2. In addition to the anterior view of the routine scintiscan, further anterior scans with reduced scan time of the gamma camera are usually necessary. This ensures better visibility of the involvement of certain morphological structures that are important for AHYS diagnosis. Moreover, a statement can be made about the inflammatory ossifying activity/inactivity of the AHYS on ACW.3. Increased radionuclide uptake in the manubrium sterni and corpus sterni on the anterior scan should be verified by additional lateral or oblique scans of the thorax (sternum).

Acne Vulgaris↗