Manubriosternal arthropathy

Case contributed by Ashesh Ishwarlal Ranchod
Diagnosis almost certain


Chronic anterior thoracic pain, particularly centered on the manubriosternal articulation.

Patient Data

Age: 50 years
Gender: Male

Limited lateral view demonstrates anterior bridging osteophytic spurring and bone erosion. The joint space is minimally reduced. There is no regional soft tissue swelling and no occult sternal bone lesions are present.

Case Discussion

The causes of manubriosternal arthropathy include inflammatory conditions such as rheumatoid and psoriatic arthritis. The sternoclavicular joint represents the most common location of SAPHO syndrome and may be included in the differential diagnosis here too. Septic arthritis (pyogenic and tuberculous) and occult metastases can be included in the broader differential diagnosis and appropriate clinical settings. Osteoarthritis and erosive osteoarthritis may represent a default diagnosis based on the exclusion of the above causes first.

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