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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
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.
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.
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