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

Area of Science:

• Rheumatology
• Dermatology
• Osteology

Background:

• Anterior thoracic wall syndrome and palmoplantar pustulosis are distinct clinical presentations.
• Differentiating rare rheumatic and musculoskeletal conditions is crucial for accurate diagnosis and management.

Observation:

• A patient presented with painful clavicular swelling, palmoplantar pustules, and elevated inflammatory markers.
• Radiological imaging revealed destructive clavicular changes with periostosis and osteosclerosis.

Findings:

• Rheumatoid factors and HLA-B27 antigen were negative, distinguishing it from common rheumatic diseases.
• The condition, termed pustulous arthroosteitis, presented with relapsing thoracic symptoms and initial palmoplantar pustulosis.
• Despite significant clavicular involvement, the patient's locomotor function remained intact over eight years.

Implications:

• Pustulous arthroosteitis represents a distinct clinical entity requiring specific diagnostic considerations.
• This case highlights the importance of integrating rheumatological, dermatological, and radiological findings for rare disease diagnosis.
• Further research into pustulous arthroosteitis is warranted to understand its pathogenesis and optimize treatment strategies.