The manubriosternal joint in rheumatoid disease

Area of Science:

• Rheumatology
• Radiology
• Anatomy

Background:

• Manubriosternal joint abnormalities are an underdiagnosed cause of chest pain.
• Establishing normal radiographic anatomy is crucial for identifying joint pathologies.

Purpose of the Study:

• To define the normal radiographic anatomy of the manubriosternal joint.
• To determine the incidence and types of manubriosternal joint abnormalities in patients with rheumatoid diseases.

Main Methods:

• Radiographic evaluation of 25 normal patients and 40 cadaver specimens.
• Analysis of manubriosternal joints in patients with rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, and Reiter syndrome.

Main Results:

• Twenty-seven of 100 manubriosternal joints showed abnormalities in rheumatoid arthritis.
• Eighty percent of ankylosing spondylitis patients (20/25) exhibited manubriosternal joint erosions or fusion.
• No erosions or ankylosis were observed in psoriatic arthritis or Reiter syndrome patients.

Conclusions:

• The manubriosternal joint is frequently affected in rheumatoid arthritis and ankylosing spondylitis.
• Evaluation of the manubriosternal articulation is recommended for patients with chest/shoulder pain and rheumatoid diseases.