In the second part of this publication, we describe some additional findings in cases of sternocostoclavicular hyperostosis. These include focal hyperostosis of the spine, in the pelvis and in the extremities and psoriatic skin lesions and severe forms of acne (acne conglobata, acne fulminans). Other features, which are not diagnostic, include erosive or non-erosive peripheral arthritis and unilateral or bilateral sacro-iliitis. An analysis of our 13 patients and of the relevant literature indicates that the hyperostosis is due to increased bone metabolism and heterotopic ossification of fibrous tissue and that these are the pathogenic bases of the changes in the axial skeleton, the pelvis and the bones of the extremities. We have suggested a scheme which would categorize the syndrome into complete, incomplete and possibly acquired forms.

We used MR angiography to assess the thoracic inlet veins in 5 normal volunteers and 14 patients with thrombosis of these veins. The results were compared with conventional venography and contrast-enhanced computed tomography (CT). The normal anatomy was readily depicted by MR angiography in all normal volunteers. Pathology was assessed correctly by MR angiography in all patients. Thrombosis of the internal jugular vein was seen on MR angiography in all cases whereas conventional venography failed to demonstrate this region adequately in 3 cases. The best overview of the thoracic inlet veins was achieved in the coronal plane; however, for detailed demonstration of pathology, imaging in additional planes was necessary. We conclude that MR angiography is a promising method for non-invasive assessment of thoracic veins.