Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Sternocostoclavicular Hyperostosis
- Radiologic Findings
- Chest radiograph (Fig.1) shows asymmetric opacities with hyperostosis of the sternum and anterior portion of the right first rib. Chest CT images (Figs. 2 and 3) show hyperostosis in the sternum, right clavicle, first rib, and manubrium.
- Brief Review
- In its classic form, sternocostoclavicular hyperostosis is characterized by distinctive bone overgrowth and soft tissue ossification of the clavicle, and anterior portion of the upper ribs, and sternum. Patients are usually in the fourth to sixth decades of life. Bilateral alterations predominate. Clinical findings include pain, swelling, and tenderness in the anterior upper chest. Osseous overgrowth may lead to occlusion of the subclavian veins. Approximately one half of patients have acne or pustular lesions with the best described association being with palmoplantar pustulosis. The term SAPHO (synovitis, acne, pustulosis, hyperostosis, osteitis) represents this spectrum of inflammatory bone disorders that is associated with dermatologic pathology.The diagnosis of sternocostoclavicular hyperostosis can be applied most confidently to an illness of adults in which bone hypertrophy and ligamentous ossification involve the structures of the anterior chest wall and in which other features, including pustular skin lesions, spinal and tubular bone involvement, and subclavian venous obstruction, may or may not be present.
- Please refer to
Case 291, Case 890, -
- References
- 1. Kohler H. From Sternocostoclavicular Hyperostosis (SCCH) to SAPHO syndrome. Curr Rheumatol Rev. 2013;9(1):15-6.
2. Jung J, Molinger M, Kohn D, et al. Intra-articular glucocorticosteroid injection into sternocostoclavicular joints in patients with SAPHO syndrome. Semin Arthritis Rheum. 2012 Dec;42(3):266-70.
- Keywords
- Chest wall, Others,