Osteolysis of the lateral clavicle - psoriasis

Case contributed by Ian Bickle
Diagnosis almost certain

Presentation

Right shoulder pain. Boggy AC joint. Tender glenohumeral joint. Skin psoriasis with marked nail changes. Bloods unremarkable.

Patient Data

Age: 35 years
Gender: Female

One year earlier for reference

x-ray

Heart size normal.   Lungs clear.

Normal mediastinal contours.

The medial aspects of both clavicles are normal.

One year later

x-ray

Subchondral lucency of the lateral aspect of the clavicle at the AC joint with associated cortical erosion.

Case Discussion

New onset osteolysis of the lateral aspect of the clavicle.

The differential for osteolysis of the lateral end of the clavicles includes psoriasis, for which a strong clinical history is provided from the primary care referrer.

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