Manubriosternal Joint Involvement as a Presenting Feature of Axial Spondyloarthritis

Oye, Melissa; Ali, Aleem Azal; Wasserman, Paul; Kaeley, Gurjit S.; Thway, Myint

doi:10.7759/cureus.20527

Cited by 2 publications

(3 citation statements)

References 13 publications

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“…Primary MSJ osteoarthritis (OA) has no identifiable etiology; secondary OA results from RA, AS, psoriatic arthritis, or gout[ 10 ]. In most cases, MSJ arthralgia due to secondary MSJ OA is accompanied by systemic symptoms, but it can be the main sign of systemic arthritis[ 11 , 12 ]. Our patient did not complain of systemic symptoms including back pain but only of anterior chest pain.…”

Section: Discussionmentioning

confidence: 99%

“…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 ]. In a retrospective study performed in 275 patients with spondyloarthritis, 37% experienced spondyloarthritis-associated chest pain[ 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…Oye et al [ 12 ] suggested anterior chest pain due to MSJ involvement as a presenting symptom of AS and MRI as a valuable diagnostic tool. MRI has been increasingly used as an imaging modality in patients with AS because of its capacity to identify both active inflammation and chronic structural changes in axial skeletal structures[ 26 ].…”

Section: Discussionmentioning

confidence: 99%

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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%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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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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Anterior Chest Wall Non-traumatic Arthropathies: A Crucial but Often Overlooked Site

Ben Nessib,

Ferjani,

Majdoub

et al. 2024

CRR

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Objective: The purpose of this study was to describe the distribution of Anterior Chest Wall (ACW) arthropathies in a tertiary care center and identify clinical, biological and imaging findings to differentiate osteoarthritis (OA) from non-osteoarthritis (N-OA) etiologies. Methods: Search from medical records from January 2009 to April 2022, including patients with manubriosternal and/or sternoclavicular and/or sternocostal joint changes confirmed by ultrasonography, computed tomography or magnetic resonance imaging. The final study group was divided into OA and N-OA subgroups. Results: A total of 108 patients (34 males and 74 females, mean age: 47.3±13 years) were included. Twenty patients had findings of OA, while 88 were diagnosed with N-OA pathologies. SpA was the most common etiology in the N-OA group (n=75). The other N-OA etiologies were less common: rheumatoid arthritis (n=4), Synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome (n=3), infectious arthritis (n=3) and microcrystalline arthropathies (n=3). Regarding the distinctive features, ACW pain was the inaugural manifestation in 50% of patients in OA group and 18.2% of patients in N-OA group (p=0.003); high inflammatory biomarkers were more common in N-OA group (p=0.033). Imaging findings significantly associated with OA included subchondral bone cysts (p<0.001) and intra-articular vacuum phenomenon (p<0.001), while the presence of erosions was significantly associated with N-OA arthropathies (p=0.019). OA was independently predicted by the presence of subchondral bone cysts (p=0.026). Conclusion: ACW pain is a common but often underestimated complaint. Knowledge of the different non-traumatic pathologies and differentiation between OA and N-OA etiologies is fundamental for appropriate therapeutic management.

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Manubriosternal Joint Involvement as a Presenting Feature of Axial Spondyloarthritis

Cited by 2 publications

References 13 publications

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

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

Anterior Chest Wall Non-traumatic Arthropathies: A Crucial but Often Overlooked Site

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