The Manubrio-Sternal Joint in Ankylosing Spondylitis

Abstract

The available information on the morbid anatomy of ankylosing spondylitis is largely concerned with the late stages when the joints have undergone bony ankylosis. The object of this paper is to draw attention to the changes which occurred in a readily accessible 56 THE JOURNAL OF BONE AND JOINT SURGERY FIG. 3 THE MANUBRIO-STERNAL JOINT IN ANKYLOSING SPONDYLITIS) I VOL.

Spondyloarthritis at the crossroads of imaging, pathology, and structural damage in the era of biologics

“…Based on a review of the available literature, Maksymowych [ 27 ] presented evidence that the primary site of infl ammation occurs at the interface of bone and cartilage, including but not limited to the enthesis. In support of this, histopathologic studies from intervertebral discs [ 30 ], femoral heads [ 31 ], SI joints [ 32 , 33 ], and the manubriosternal junction [ 34 ] suggest that a subchondral infl ammation at the interface between bone and cartilage (a subchondral osteitis) could be the primary site of the AS immunopathology, also without involvement of an enthesis. Among these, an interesting publication from Bywaters and Olsen [ 31 ] in 1968 reported on a postmortem case of a 21-year-old AS patient with hip arthritis.…”

Analysis of Bone Samples from Patients with Spondyloarthritides—Identifying Causes of New Bone Formation in Axial Spondyloarthritis

“…In addition to inflammation, we found cartilage degeneration, indicated by cartilage thinning, enhanced chondrocyte apoptosis and proteoglycan loss, and subchondral bone thinning, promoted by the invasion of fibrous tissue originating from the bone marrow through the subchondral bone endplate, as hallmarks of joint remodeling in AS 10 . The presence of fibrous tissue as a main histomorphological finding located at sites with less inflammation but already showing bone destruction (i.e., bone endplate) and the formation of osteoblasts within the same tissue with features of direct bone formation has also been reported extensively in historical histological analyses by Cruickshank 2 , Bywaters and Olsen 3 , Savill 7 , and Francois, et al 6 .…”

Ankylosing Spondylitis: A Survey

“…This bony tenderness may need local therapy and may mislead the diagnostician, for the punched-out areas seen in x-ray photographs may be mistaken for tuberculous disease if in an abnormal site such as the shoulder, or the vertebral body. Involvement of the sternomanubrial joint has been described by Savill (1951), Solovay and Gardner (1951), and Franqon and others (1953). Davis and Blair (1950) emphasize the frequency of calcaneal periostitis or spurs in this condition.…”