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Monarthritis of the manubriosternal joint. A follow-up study
Abstract:
Six women and three males, who initially had seronegative monarticular arthritis of the manubriosternal joint (MSJ) were followed for a mean period of 7.1 years (range 0.8-17 years). Rather severe, progressive disease occurred in five patients, three of whom had pustulosis palmoplantaris (PPP) and one acne vulgaris. The course was milder in four patients who had either psoriasis vulgaris, psoriasis in the family or HLA-B27, and the disease remained localized to the MSJ in these patients. None of the patients developed sacroiliitis or peripheral erosive joint changes, but one patient with PPP developed paravertebral ossification.
Insights
This study followed nine patients with seronegative manubriosternal joint arthritis. Five experienced severe disease, often linked to pustulosis palmoplantaris, while four had milder, localized arthritis.
Area of Science:
- Rheumatology
- Immunology
- Dermatology
Background:
- Seronegative monarticular arthritis affecting the manubriosternal joint (MSJ) is uncommon.
- Understanding its natural history and associations is crucial for patient management.
Purpose of the Study:
- To investigate the long-term outcomes and clinical course of patients with seronegative arthritis of the MSJ.
- To identify potential associations between MSJ arthritis and other conditions like psoriasis and acne.
Main Methods:
- A longitudinal follow-up study of nine patients (six women, three males) diagnosed with seronegative monarticular arthritis of the MSJ.
- Mean follow-up duration of 7.1 years (range 0.8-17 years).
- Clinical assessment for disease severity, progression, and associated conditions.
Main Results:
- Five patients experienced severe, progressive disease, with three having pustulosis palmoplantaris (PPP) and one acne vulgaris.
- Four patients had a milder disease course, localized to the MSJ, associated with psoriasis vulgaris, family history of psoriasis, or HLA-B27.
- No sacroiliitis or peripheral erosive joint changes were observed; one patient with PPP developed paravertebral ossification.
Conclusions:
- Seronegative MSJ arthritis can present with variable severity and progression.
- Associations with dermatological conditions like PPP and psoriasis may influence disease course.
- MSJ arthritis appears to have a distinct clinical pattern without sacroiliitis or peripheral erosions in this cohort.