Seronegative arthritides of the anterior chest wall: a follow-up study

Fourteen patients with arthritis of the anterior chest wall (ACW) as part of ankylosing spondylitis, reactive arthritis, and arthritis associated with psoriasis and/or pustulosis palmoplantaris (PPP) were re-examined after periods of 5-15 years (mean 9 years) using tomography. The findings were compared with those of 24 similarly examined patients with predominant osseous sclerotic ACW lesions or monarthritis of the manubriosternal joint. Pronounced osseous hyperostosis in the region of the sternoclavicular joint accompanied by ossification of the costoclavicular ligament was found to occur only in patients with PPP lesions. Patients with ankylosing spondylitis and reactive arthritis developed slight or moderate hyperostosis only and no ligament ossification. Predominant osseous sclerotic sternal and clavicular lesions occurred in patients with PPP and in patients without skin disease or traits suggesting well-known arthritides, but not as part of ankylosing spondylitis and reactive arthritis. Arthritis of the manubriosternal joint and upper sternocostal joints developed in all forms of arthritis.