[Pustular arthro-osteitis. A new entity among rheumatic diseases?]

A patient is shown with symptoms of the anterior thoracic wall syndrome and pustulous changes on the palms an soles. In the clinical picture, a painful swelling of the medial third of the right clavicle dominated, while the general state of the patient was good. Laboratory findings showed positive tests of inflammatory activity, while the rheumatoid factors and the HLA B 27 antigen were negative. Radiologically wide-spread destructive changes of the medial part of the right clavicle were found, with signs of periostosis in the active phase of the disease and osteosclerosis in remission. The symptoms of the anterior thoracic wall have often relapsed, while the plamo-plantar pustulosis was present only at the onset of the disease. The function of locomotor system remained undamaged even after eight years of the disease duration. The disease was, after its clinical, laboratory and radiological aspect, different from all up to now known rheumatic diseases as well as from other diseases with symptoms on the locomotor system. It fits into the syndrome which was described by japanese authors under the name of "pustulous arthroosteitis".