OLGU SUNUMLARI
Spondiloartritlerde Önemli Bir Eklem Tutulumu: Sternoklavikular Artrit
An Important Joint Involvement in Spondyloarthritis: Sternoclavicular Arthritis
Received Date : 12 Oct 2021
Accepted Date : 28 Mar 2022
Available Online : 31 Mar 2022
Senem ŞAŞa, Hüseyin KAPLANa, Emre ŞENKÖYa, Gizem CENGİZa
aErciyes Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon ABD, Romatoloji BD, Kayseri, Türkiye
Doi: 10.31609/jpmrs.2021-86624 - Makale Dili: TR
J PMR Sci. 2022;25(2):269-72
ÖZET
Spondiloartrit, aksiyel iskeleti ve periferik eklemleri etkileyen
benzer klinik ve patofizyolojik mekanizmalara sahip heterojen kronik
inflamatuar hastalık grubudur. Sıklıkla 2 ve 3. dekadda görülmektedir.
Romatoid faktörün negatifliği, insan lökosit antijeni B27 doku antijeninin
pozitifliği, sakroiliit ve spondilit tutulum, öncelikle alt ekstremite
eklemlerini tutan periferik oligoartrit, entezopati varlığı, ürogenital sistem
ve bağırsak enfeksiyonu, psöriyatik deri lezyonları, anterior üveit
atakları, özellikle genç yaşlarda başlangıç ve ailesel genetik yatkınlık bu
grubun bilinen ortak klinik özelliklerindendir. Aksiyel spondiloartritte
primer olarak sakroiliyak eklem ve omurga etkilenir. Ayrıca değişen
oranlarda göğüs ön duvarı tutulumuda olabilir. Sternoklavikular eklem,
manubriosternal eklem ve sternokostal eklemlerin artiriti neticesinde
göğüs ön duvarında ağrı oluşmaktadır. Sternoklavikular eklemi etkileyen
hastalıkların ayırıcı tanısı, erken tanı ve uygun tedavi prosedürleri
açısından önemlidir. Bu yazıda, sternoklavikular eklem tutulumunun
eşlik ettiği bir aksiyel spondiloartrit olgusu güncel literatür eşliğinde
sunulmaktadır.
Anahtar Kelimeler: Sakroiliit; sternoklavikular eklem; göğüs ağrısı; spondiloartrit
ABSTRACT
Spondyloarthritis is a heterogeneous group of chronic inflammatory
diseases with similar clinical and pathophysiological mechanisms
affecting the axial skeleton and peripheral joints. It is frequently
seen in the 2nd and 3rd decades. Negative rheumatoid factor, positivity
of human leukocyte antigen B27 tissue antigen, sacroiliitis and
spondylitis, primarily involving lower extremity joints peripheral
oligoarthritis, presence of enthesopathy, urogenital system and intestinal
infections, psoriatic skin lesions, anterior uveitis attacks, especially
onset at young ages and familial genetic predisposition are the common
clinical features of the group. In axial spondyloarthritis, the
sacroiliac joint and spine are primarily affected. In addition, anterior
chest wall involvement has been reported at varying rates. Pain occurs
in the anterior chest wall as a result of arthritis of the sternoclavicular
joint, manubriosternal joint and sternocostal joints. Differential diagnosis
of diseases affecting the sternoclavicular joint is important in
terms of early diagnosis and appropriate treatment procedures. In this
article, a case of axial spondyloarthritis accompanied by sternoclavicular
joint involvement is presented in the light of current literature.
Keywords: Sacroiliitis; sternoclavicular joint; chest pain; spondyloarthritis
REFERENCES
- Carron P, De Craemer AS, Van den Bosch F. Peripheral spondyloarthritis: a neglected entity-state of the art. RMD Open. 2020;6:e001136. [Crossref] [PubMed] [PMC]
- Nikiphorou E, Baraliakos X. Treat to target in axial spondyloarthritis. Rheum Dis Clin North Am. 2019;45:519-35. [Crossref] [PubMed]
- Rennie WJ, Jans L, Jurik AG, et al. Anterior chest wall in axial spondyloarthritis: imaging, interpretation, and differential diagnosis. Semin Musculoskelet Radiol. 2018;22:197-206. [Crossref] [PubMed]
- Lee TH, Lee CM, Kim TH, et al. Anterior chest wall involvement in spondyloarthritis patients as detected by magnetic resonance imaging: a case series and literature review. Journal of Rheumatic Diseases. 2021;28:159-64. [Crossref]
- Huang PY, Chang LS, Guo MM, et al. Successful treatment in a child with enthesitis-related arthritis involving the sternoclavicular joint: a case report. BMC Pediatr. 2019;19:373. [Crossref] [PubMed] [PMC]
- Elhai M, Paternotte S, Burki V, et al. Clinical characteristics of anterior chest wall pain in spondyloarthritis: an analysis of 275 patients. Joint Bone Spine. 2012;79:476-81. [Crossref] [PubMed]
- Sas S, Erdem HR, Uysal B. Brucellar arthritis involving left sternoclavicular joint: a case report. Acta Med Anatol. 2016;4:126-8. [Crossref]
- Edwin J, Ahmed S, Verma S, et al. Swellings of the sternoclavicular joint: review of traumatic and non-traumatic pathologies. EFORT Open Rev. 2018;3:471-84. [Crossref] [PubMed] [PMC]
- Durmaz HÖ, Erdem HR. [Tietze's syndrome: a case report]. YIU Saglik Bil Derg. 2021;2:63-6. [Crossref]
- Kawashiri SY, Edo Y, Kawakami A. Early detection of inflammation and joint destruction revealed by ultrasound in a patient with sternoclavicular septic arthritis. Intern Med. 2019;58:865-9. [Crossref] [PubMed] [PMC]
- Kang BS, Shim HS, Kwon WJ, et al. MRI findings for unilateral sternoclavicular arthritis: differentiation between infectious arthritis and spondyloarthritis. Skeletal Radiol. 2019;48:259-66. [Crossref] [PubMed]
- Verhoeven F, Guillot X, Godfrin-Valnet M, et al. Ultrasonographic evaluation of the anterior chest wall in spondyloarthritis: a pros- pective and controlled study. J Rheumatol. 2015;42:87-92. [Crossref] [PubMed]
- Zwaenepoel T, Vlam K. SAPHO: Treatment options including bisphosphonates. Semin Arthritis Rheum. 2016;46:168-73. [Crossref] [PubMed]
- Min KS, Lopez A, Powlan FJ, et al. Ultrasound-guided sternoclavicular joint injection: technique and case series. JSES Reviews, Reports, and Techniques. 2021;1:393-7. [Crossref]
- Sencan S, Güler E, Cüce I, et al. Fluoroscopy-guided intra-articular steroid injection for sternoclavicular joint arthritis secondary to limited cutaneous systemic sclerosis: a case report. Korean J Pain. 2017;30:59-61. [Crossref] [PubMed] [PMC]