Swellings of the sternoclavicular joint: review of traumatic and non-traumatic pathologies

Edwin, John; Ahmed, Shahbaz; Verma, Shobhit; Tytherleigh-Strong, Graham; Karuppaiah, Karthik; Sinha, Joydeep

doi:10.1302/2058-5241.3.170078

Cited by 19 publications

(19 citation statements)

References 146 publications

(254 reference statements)

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“…First, there was no control group. Some other diseases may involve the ACW, such as osteoarthritis, septic arthritis, and other inflammatory conditions [ 20 , 34 ]. Inclusion of control groups may help with better interpretation of the findings in SAPHO syndrome.…”

Section: Discussionmentioning

confidence: 99%

Anterior chest wall in SAPHO syndrome: magnetic resonance imaging findings

Cao

et al. 2020

Arthritis Res Ther

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Background The anterior chest wall (ACW) involvement is characteristic of synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome, yet little research has focused on its magnetic resonance imaging (MRI) findings. Purpose To characterize the MRI features of the ACW in patients with SAPHO syndrome. Methods Seventy-one patients with SAPHO syndrome and ACW involvement evidenced by bone scintigraphy were recruited in this cross-sectional study. The ACW region was scanned using sagittal, axial, and oblique coronal Dixon T2-weighted sequences and axial Dixon T1-weighted sequences. The characteristics of both active inflammatory and chronic structural lesions were evaluated. Results The ACW lesions exhibited an asymmetrical distribution and a predilection for the sternocostoclavicular region (93.0%). Notably, 91.5% of the patients had lesions in the area of the anterior first ribs. Bone marrow edema (BME) was observed in 63 (88.7%) patients, which mainly affected the sternocostal joints (87.3%) and the manubrium sterni (84.5%). All of the BMEs were distributed under the articular surface or the bone cortex, consistent with the distribution of the ligaments and joint capsules. Synovitis was detected in 64 (90.1%) patients, with a predilection for the sternoclavicular joints (76.1%). A soft tissue mass or infiltration was found in all the patients who had bone marrow edema. Thirteen (18.3%) patients showed venous stenosis. Structural changes included bone bridge formation (80.3%), hyperostosis (43.7%), and fat infiltration (39.4%). Four common patterns of involvement were observed: the first rib area, the sternoclavicular area, the sternal angle area, and the areas of the second to sixth sternocostal joints. Conclusion The ACW lesions of SAPHO syndrome demonstrated a triad of enthesitis, synovitis, and osteitis, suggesting complex interactions among the ligaments, synovium, and bones in the region. The inflammatory changes in the first rib area were highlighted in SAPHO syndrome.

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Section: Discussionmentioning

confidence: 99%

Anterior chest wall in SAPHO syndrome: magnetic resonance imaging findings

Cao

et al. 2020

Arthritis Res Ther

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“…These are treated with antiinflammatory medications and corticosteroid injections locally. 8 However, it can present as a swelling of joint which can mimic tumour like present case.…”

Section: Discussionmentioning

confidence: 59%

“…All these systemic diseases need to be excluded to make the right diagnosis. 8 Initial screening tests such as inflammatory markers (white cell count, erythrocyte sedimentation rate (ESR), C-Reactive Protein (CRP), rheumatoid factor (RA), Antinuclear Antibodies (ANA) and tissue antigen tests for Human Leukocyte Antigen (HLA-B27) are useful to diagnose chronic inflammatory conditions and infections. However, in this case, due to the presentation and the absence of any inflammatory signs, the patient was directly refereed for radiography tests.…”

Section: Discussionmentioning

confidence: 99%

Atraumatic spontaneous swelling of sternoclavicular joint: a case report

2020

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Atraumatic spontaneous swelling of the Sternoclavicular Joint (SCJ) is not very common in elderly women. The SCJ is an integral part of the shoulder girdle that connects the upper limb to the axial skeleton. Trauma, degeneration, infections and other disease processes that affect synovial joints are the common causes of swelling of the SCJ. Here authors report a case of nontraumatic spontaneous anterior subluxation of the sternoclavicular joint in 66-year-old women without any underlying pathology who presented with sudden onset of a nontender swelling in the suprasternal area. The patient was treated conservatively and remained asymptomatic throughout 6 months follow up.

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“…Ayırıcı tanıda dü-şünülmesi gereken bir diğer hastalık olan sinovitakne-püstüloz-hiperostoz-osteit (SAPHO) sendromunun erken döneminde osteolitik kemik yıkımı beklenirken, geç döneminde hiperostoz ve skleroz gibi osteoproliferatif değişiklikler görülür. 3,8 Romatoid artritli hastalarda, sternoklavikular eklem tutulumu diğer eklemlerdeki etkilenmelere benzer şekildedir. Seronegatif SpA'larda ve kristal artropatilerde de sternoklavikular eklemde tutulum olabilir.…”

Section: Discussionunclassified