First Asian case of biopsy-confirmed manubriosternal joint involvement in rheumatoid arthritis

Kim, Y.; Kim, G.-T.; Lee, S.-G.; Lee, H.-N.; Kang, Jihun; Ko, Tsung‐Yu

doi:10.1007/s00393-020-00763-w

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“…The most characteristic clinical symptom of AS is inflammatory back pain. Pain and stiffness in the mid-thoracic or cervical region may be the initial symptom instead of the more common presentations of AS[ 15 ]. On the other hand, MSJ causing anterior chest pain is a rare presenting symptom[ 12 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided intra-articular corticosteroid injection in a patient with manubriosternal joint involvement of ankylosing spondylitis: A case report

Choi¹,

Yoon²,

Kim³

2023

World J Clin Cases

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BACKGROUND Manubriosternal joint (MSJ) disease is a rare cause of anterior chest pain but can be a major sign of systemic arthritic involvement. In patients with ankylosing spondylitis (AS), a type of systemic arthritis, chest pain can be due to MSJ involvement and can be improved by ultrasound-guided corticosteroid injection into the joint. CASE SUMMARY A 64-year-old man visited our pain clinic complaining of anterior chest pain. There were no abnormal findings on lateral sternum X-ray, but arthritic changes in the MSJ were observed on single-photon emission computed tomography-computed tomography. We performed additional laboratory tests, and he was finally diagnosed with AS. For pain relief, we performed ultrasound-guided intra-articular (IA) corticosteroid injections into the MSJ. After the injections, his pain nearly resolved. CONCLUSION For patients complaining of anterior chest pain, AS should be considered, and single-photon emission computed tomography-computed tomography can be helpful in diagnosis. In addition, ultrasound-guided IA corticosteroid injections may be effective for pain relief.

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Section: Discussionmentioning

confidence: 99%