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Titolo:
The sternoclavicular syndrome: experience from a district general hospitaland results of a national postal survey
Autore:
Kalke, S; Perera, SD; Patel, ND; Gordon, TE; Dasgupta, B;
Indirizzi:
Southend Gen Hosp, Dept Rheumatol, Westcliff On Sea SS0 0RY, Essex, England Southend Gen Hosp Westcliff On Sea Essex England SS0 0RY , Essex, England Southend Gen Hosp, Dept Radiol, Westcliff On Sea SS0 0RY, Essex, England Southend Gen Hosp Westcliff On Sea Essex England SS0 0RY , Essex, England
Titolo Testata:
RHEUMATOLOGY
fascicolo: 2, volume: 40, anno: 2001,
pagine: 170 - 177
SICI:
1462-0324(200102)40:2<170:TSSEFA>2.0.ZU;2-B
Fonte:
ISI
Lingua:
ENG
Soggetto:
COSTO-CLAVICULAR OSSIFICATION; PUSTULOTIC ARTHRO-OSTEITIS; STERNOCOSTOCLAVICULAR HYPEROSTOSIS; CLINICAL-FEATURES; SAPHO SYNDROME; CONDENSING OSTEITIS; TIETZES SYNDROME; ARTHROOSTEITIS;
Keywords:
SAPHO syndrome; hyperostosis; sternoclavicular joint;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
28
Recensione:
Indirizzi per estratti:
Indirizzo: Dasgupta, B Southend Gen Hosp, Dept Rheumatol, Westcliff On Sea SS0 0RY, Essex, England Southend Gen Hosp Westcliff On Sea Essex England SS0 0RY land
Citazione:
S. Kalke et al., "The sternoclavicular syndrome: experience from a district general hospitaland results of a national postal survey", RHEUMATOLOG, 40(2), 2001, pp. 170-177

Abstract

Objective. To report our local experience of the sternoclavicular syndromeand sample the experience of other rheumatologists in the UK. Methods. We studied case records of 23 patients referred to the Southend rheumatology clinic and data obtained from a postal questionnaire survey of British rheumatologists. Results. We describe 58 cases (20 males and 38 females, mean age 47.2 yr). The disease was unilateral in 40 patients. Shoulder and/or arm pain (38 cases) with limitation of shoulder movements was an important presenting feature; other presenting features were anterior chest wall pain (14 cases) andneck pain (15 cases). Peripheral joint involvement was seen in 12 cases. Skin rash was reported in 12 cases (psoriasis, 6; acne, 2; none had pustulosis). No patients had symptoms or signs of sacroiliitis, and HLA-B27 was negative in 22 out of 23 patients. (99)Technetium scintiscanning showed increased uptake in the sternoclavicular region in 31/34 patients (91.1%), but not in the sacroiliac areas. Plain radiographs were abnormal in 18 cases (sclerosis, 9; erosions, 2; soft tissue swelling, 2; bony expansion, 5). CT and/or MRI scans (available in 27 cases) showed erosions in 12 and osteitis in18. Available histology showed a variable picture, including inflammation,bone erosion, sterile osteomyelitis and fibrosis. The majority of patients(45) were treated with non-steroidal anti-inflammatory drugs: 12 received steroids and 10 received disease-modifying anti-rheumatic drugs (methotrexate, 4; sulphasalazine, 6). Follow-up information was available for 38 patients, of whom 14 became asymptomatic and 24 had chronic disease with intermittent flares. Conclusion. Sternoclavicular disease is not uncommon in the UK. It can present with pain in the shoulder, neck or anterior chest wall, and may be underdiagnosed. Our results do not show a link with acne or pustulosis. Features of spondyloarthropathies, such as sacroiliitis and HLA-B27 positivity, were rare in this survey.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 06/04/20 alle ore 05:22:40