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Acquired hyperostosis syndrome: Spectrum of manifestations at the sternocostoclavicular region. Radiologic evaluation of 34 cases

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Summary

Thirty-four patients with chest wall hyperostosis, a condition which has been designated by various terms in the literature were evaluated radiologically. We prefer the name acquired hyperostosis syndrome (AHS), which we categorize into the complete, incomplete and possible form. In complete AHS, sternocostoclavicular hyperostosis is associated with axial and/or peripheral (endosteal, periosteal, enthesopathic, metaplastic) hyperostosis and with psoriasiform or acneform dermatosis. In addition, these three manifestations are accompanied by erosive or nonerosive peripheral and/or axial arthritis to a variable degree. Sometimes, concomitant findings which are consistent with ankylosing spondylitis are also to be found in the axial skeleton. AHS is manifested at 11 different sites on the anterior chest wall. Ossification forms of the costal cartilage, inflammatory enthesopathies (three different insertions) and focal hyperostoses as well as processes of remodelling of the ribs, clavicles and sternum which are described in detail have particular diagnostic significance. AHS can start simultaneously at one, two or several sites on the anterior chest wall. Conventional tomography (possibly supplemented by CT) is necessary for early diagnosis and for analysis of the various findings on the anterior chest wall.

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References

  1. Bechthold, R.E., Karstaedt, N., Wolfman, N.T. MR appearance of sternal hyperostosis. J Comp Ass Tomogr 1990, 14, 136–139.

    Google Scholar 

  2. Benhamou, C.L., Chamot, A.M., Kahn, M.F. Synovitis-acne-pustulosis hyperostosis-osteomyelitis syndrome (Sapho). A new syndrome among the spondylarthropathies? Clin Exp Rheum 1988, 6, 109–112.

    Google Scholar 

  3. Béraneck, L., Kaplan, G., Benoist, M., Bouchon, J.P., Prost, A., Vassal, J.P., Kahn, M.F. Hyperostose multiple avec sacroi-iliite unilatérale. Une nouvelle spondylarthropathie. Presse Méd 1984, 13, 2001–2004.

    Google Scholar 

  4. Béraneck, L., Kaplan, G. Les hyperostoses thoraciques. Description, nosologie, étiologies. Rev Rhum 1985, 52, 427–430.

    PubMed  Google Scholar 

  5. Björkstén, B., Gustavson, K-H., Eriksson, B., Lindholm, Å., Nordström, S., Chronic recurrent multifocal osteomyelitis and pustulosis palmoplantaris. J Pedriatr 1978, 93, 227–231.

    Google Scholar 

  6. Björkstén, B., Boquist, L., Histopathological aspects of chronic recurrent multifocal osteomyelitis. J Bone Joint Surg 1980, 62 B, 376–380.

    PubMed  Google Scholar 

  7. Brandon, C., Martel, W., Weatherbee, L., Capek, P. Case report (osteosclerotic myeloma) (POEMS syndrome). Skelet Radiol 1989, 18, 542–546.

    Google Scholar 

  8. Calabro, J.J., Jeghers, H., Millerka, Gordon, R.D. Classification of anterior chest wall syndromes. J Am Med Assoc 1980, 243, 1420–1421.

    Google Scholar 

  9. Cameron, H.U., Fornasier, V.L. The manubriosternal joint—an anatomicoradiological survey. Thorax 1974, 22, 472–474.

    Google Scholar 

  10. Cave, A.J.E. The nature and morphology of the costoclavicular ligament. J Anat 1961, 95, 170–179.

    PubMed  Google Scholar 

  11. Chamot, A.M., Benhamou, C.L., Kahn, M.F., Béraneck, L., Kaplan, G., Prost, A. Le syndrome acné pustulose hyperostose ostéite (acronyme: SAPHO). Résultats d'une enquête nationale. 85 observations.Rev. Rhum 1987, 54, 187–196.

    PubMed  Google Scholar 

  12. Chigira, M., Maehara, S., Nagase, M., Ogimi, T., Udagawa, E. Sternocostoclavicular hyperostosis. A report of nineteen cases with special reference to etiology and treatment. J Bone Joint Surg 1986, 68A, 103–112.

    Google Scholar 

  13. Chigira, M., Shimizu, T. Computed tomographic appearances of sternocostoclavicular hyperostosis. Skelet Radiol 1989, 18, 347–352.

    Google Scholar 

  14. Colhoun, E.N., Hayward, C., Evans, K.T. Inter-sterno- costoclavicular ossification. Clin Radiol 1987, 38, 33–38.

    PubMed  Google Scholar 

  15. Dihlmann, W. Fibroostosis und Fibroostitis (Terminologie, Röntgenmorphologie, Traceruntersuchungen). Z Orthop 1974, 112, 1242–1248.

    PubMed  Google Scholar 

  16. Dihlmann, W. Joints and vertebral connections. Clinical radiology. Thieme Inc, New York, 1985, pg. 72f.

    Google Scholar 

  17. Dihlmann, W., Hering, L., Bargon, G.W. Das akquirierte Hyperostose-Syndrom (AHS). Synthese aus 13 eigenen Beobachtungen von sternokostoklavikulärer Hyperostose und über 300 Fällen aus der Literatur—Teil 1. Fortschr Röntgenstr1988a, 149, 386–391.

    Google Scholar 

  18. Dihlmann, W., Hering, L., Bargon, G.W. Das akquirierte Hyperostose-Syndrom. Teil 2 Fortschr Röntgenstr 1988b, 149, 596–602.

    Google Scholar 

  19. Döhler, R., Herrlinger, J.D. Hyperostose der Sternoklavikulargelenke—eine Enthesopathie? Z Orthop 1983, 121, 92–97.

    PubMed  Google Scholar 

  20. Edlund, E., Johnsson, U., Lidgren, L., Pettersson, H., Sturfelt, G., Svensson, B., Theander, J., Willén, H. Palmoplantar pustulosis and sternocostoclavicular arthro-osteitis. Ann Rheum Dis 1988, 47, 809–815.

    PubMed  Google Scholar 

  21. Fallet, G.H., Arroyo, J., Visher, T.L. Sternocostoclavicular hyperostosis: case report with a 31-year follow up. Arthritis Rheum 1983, 26, 784–790.

    PubMed  Google Scholar 

  22. Fallet, G.H., Lagier, R., Gerster, J-C, Arroyo, J. Sternocostoclavicular hyperostosis (SCCHO) with palmoplantar pustulosis (PPP). Clin Exp Rheumatol 1987, 5, 135–141.

    PubMed  Google Scholar 

  23. Fournié, A., Bouvier, M., Fournié, B., Colson, F., Ayrolles, C., Larbre, J.P. Hyperostose-ostéite-periostité triade radiologique des enthésopathies. Remarques à propos de deux localisations fémorales inhabituelles. Rev Rhum 1989, 56, 763–766.

    PubMed  Google Scholar 

  24. Furukawa, M., Miwa, T., Kamide, M., Sakumoto, M., Umeda, R. Three cases of inter-sterno-costo-clavicular ossification associated with tonsillar infection. J Laryng Otol 1989, 103, 783–786.

    Google Scholar 

  25. Gerster, J.C., Lagier, R., Nicod, L. Case report 131 (Sternocostoclavicular hyperostosis). Skeletal Radiol 1985, 14, 53–60.

    PubMed  Google Scholar 

  26. Grosbois, B., Pawlotsky, Y., Chalès, G., Meadeb, J., Carsin, M., Louboutin, J.Y. Etude clinique et radiologique de l'articulation manubrio-sternale. Comparison entre 80 sujets témoins et 88 patients atteints de rhumatismes inflammatoires chroniques. Rev Rhum 1981, 48, 495–503.

    PubMed  Google Scholar 

  27. Heimstädt, P. Ein Fall von sterno-kosto-klavikulärer Hyperostose. Verh Dtsch Ges Rheumatol 1978, 5, 334–335.

    PubMed  Google Scholar 

  28. van Holsbeeck, M., Martel, W., Dequeker, J., Favril, A., Gielen, J., Verschakelen, J., Hoogmartens, M. Soft tissue involvement, mediastinal pseudotumor, and venous thrombosis in pustulotic arthro-osteitis. A study of eight new cases. Skeletal Radiol 1989, 18, 1–8.

    PubMed  Google Scholar 

  29. Huaux, J.P., Maldague, B., Malghem, J., Meunier, H., Noël, H., Nagant de Deuxchaisnes, C. Pustulotic arthroosteitis and related disorders in children and adults. A report of 7 cases. J Belg Radiol 1986, 69, 345–354.

    PubMed  Google Scholar 

  30. Huaux, J.P., Esselinckx, W., Meunier, H., Malghem, J., Maldague, B., Nagant de Deuxchaisnes, C. Pustulotic arthroosteitis in children and adults. A report of 13 cases. Clin Exp Rheumatol 1987, 5, 143–146.

    PubMed  Google Scholar 

  31. Jurik, A.G., Graudal, H., de Carvalho, A. Sclerotic changes of the manubrium sterni. Skeletal Radiol 1985, 13, 195–201.

    PubMed  Google Scholar 

  32. Jurik, A.G., Graudal, H. Monaarthritis of the manubriosternal joint. A follow-up study. Rheumatol Intern 1987, 7, 235–241.

    Google Scholar 

  33. Jurik, A.G., Graudal, H. Sternocostal joint swelling—clinical Tietze's syndrome. Report of sixteen cases and review of the literature. Scand J Rheumatol 1988, 17, 33–42.

    PubMed  Google Scholar 

  34. Jurik, A.G., Helmig, O., Graudal, H., Skeletal disease, arthro-osteitis, in adult patients with pustulosis palmoplantaris. Scand J Rheumatol 1988, Suppl 70, 1–15.

    Google Scholar 

  35. Jurik, A.G., Møller, S.H., Mosekilde, L. Chronic sclerosing osteomyelitis of the iliac bone. Etiologic possibilities. Skeletal Radiol 1988, 17, 114–118.

    PubMed  Google Scholar 

  36. Jurik, A.G., Ternowitz, T. Frequency of skeletal disease, arthroosteitis in patients with pustulosis palmoplantaris. J Am Acad Dermatol 1988, 18, 666–671.

    PubMed  Google Scholar 

  37. Kasperczyk, A., Freyschmidt, J., Ostertag, H. Tumorsimulierende Knochenläsionen bei sternokostoklavikulärer Hyperostose und Pustulosis palmoplantaris. Fortschr Röntenstr 1990, 152, 10–15.

    Google Scholar 

  38. Katz, M.E., Shier, C.K., Ellis, B.I., Leisen, J.C.C., Hardy, D.C., Jundt, J.W. A unified approach to symptomatic juxtasternal arthritis and enthesitis. Am J Roentgenol 1989, 153, 327–333.

    Google Scholar 

  39. Kawai, K., Doita, M., Tateishi, H., Hirohata, K. Bone and joint lesions with pustulosis palmaris et plantaris. A clinical and histological study. J Bone Joint Surg 1988, 70B, 117–122.

    Google Scholar 

  40. Köhler, H., Uehlinger, E., Kutzner, J., Weihrauch, T.R., Wilbert, L., Schuster, R. Sterno-kosto-klavikläre Hyperostose ein bisher nicht beschriebenes Krankheitsbild. Dtsch Med Wochenstr 1975, 100, 1519–1523.

    Google Scholar 

  41. Köhler, H., Uehlinger, E., Kutzner, J., West, T.B. Sternocostoclavicular hyperostosis: painful swelling of the sternum, clavicles, and upper ribs. Report of two new cases. Ann Intern Med 1977, 87, 192–194.

    PubMed  Google Scholar 

  42. Kurc, D., de Saint-Père, R., Madoule, Ph., Laoussa, D.I., Caquet, R. Les ostéites et arthrites chroniques de la pustulose palmoplantaire. Une forme familiale de spondylarthropathie B27 négative. Rev Med Interne 1987, 8, 79–84.

    PubMed  Google Scholar 

  43. Le Goff, P., Brousse, A., Fauquert, P., Guillet, G., Leroy, J.P. Arthropathies érosives thoraciques antérieures et intervertébrales associées à la pustulose palmoplantaire. Rev Rhum 1985, 52, 391–396.

    PubMed  Google Scholar 

  44. Péré, P., Fagart, J.P., Régent, D., Bannwarth, B., Gaucher, A. Les hyperostoses sterno-costo-claviculaires. Conceptions nosologiques. J Radiol 1987, 68, 809–814.

    PubMed  Google Scholar 

  45. Prinzmetal, M., Massumi, R.A. The anterior chest wall syndrome—chest pain resembling pain of cardiac origin. J Am Med Assoc 1955, 159, 177–183.

    PubMed  Google Scholar 

  46. Probst, F.P., Chronic multifocal cleido-metaphyseal osteomyelitis of childhood. Report of a case. Acta Radiol Diagn 1976, 17, 531–537.

    Google Scholar 

  47. Probst, F.P., Björksten, B., Gustavson, K.H., Radiological aspect of chronic recurrent multifocal osteomyelitis. Ann Radiol (Paris) 1978, 21, 115–125.

    Google Scholar 

  48. Prost, A., Dupas, B., Rymer, R., Caumon, J-P., Basle, M., Rebel, A. Hyperostose sterno-costo-claviculaire. A propos de deux observations dont une forme partielle. J Radiol 1980, 61, 807–812.

    PubMed  Google Scholar 

  49. Pučar, I., Dürrigl, Th., Škarica, R. Pustulöse Arthroosteitis. Eine neue Entität unter den rheumatischen Krakheiten? Z Rheumatol 1984, 43, 148–151.

    PubMed  Google Scholar 

  50. Resnick, D. Sternocostoclavicular hyperostosis. Am J Roentgenol 1980, 135, 1278–1280.

    Google Scholar 

  51. Resnick, D., Vint, V., Poteshman, N.L., Sternocostoclavicular hyperostosis. A report of three new cases. J Bone Joint Surg 1981, 63A, 1329–1332.

    Google Scholar 

  52. Rosner, I.A., Richter, D.E., Huettner, T.L., Kuffner, G.H., Wisnieski, J.J., Burg, C.G. Spondylarthropathy associated with hidradenitis suppurativa and acne conglobata. Ann Intern Med 1982, 97, 520–525.

    PubMed  Google Scholar 

  53. Sartoris, D.J., Schreiman, J.S., Kerr, R., Resnick, C.S., Resnick, D. Sternoclavicular hyperostosis: a review and report of 11 cases. Radiology 1986, 158, 125–128.

    PubMed  Google Scholar 

  54. Sasaki, T. A case of bilateral clavicular osteomyelitis accompanied with pustulosis palmaris et plantaris. Japanese J Clin Orthop 1967, 2, 333–337 (as quoted by Furukawa et al).

    Google Scholar 

  55. Shier, C.K., Katz, M.E., Ellis, B.I., Leisen, J.J.C., Hardy, D.C., Jundt, J.W., Juxtasternal arthro-osteitis: a polyetiologic condition. Radiology 1987, 165 (P), Suppl, 233.

    PubMed  Google Scholar 

  56. Solheim, L.F., Paus, B., Liverud, K., Støen, E. Chronic recurrent multifocal osteomyelitis. A new clinical radiological syndrome. Acta Orthop Scand 1980, 51, 37–41.

    PubMed  Google Scholar 

  57. Sonozaki, H., Azuma, A., Okai, K., Nakamura, K., Fukuoka, S. et 11 al. Clinical features of 22 cases with “inter-sterno-costo-clavicular ossification”. A new rheumatic syndrome. Arch Orthop Traumat Surg 1979, 95, 13–22.

    Google Scholar 

  58. Sonozaki, H., Mitsui, H., Miyanaga, Y., Okitsu, K., Igarashi, M. et al. Climical features of 53 cases with pustulotic arthro-osteitis. Ann Rheum Dis 1981, 40, 547–553.

    PubMed  Google Scholar 

  59. Sonozaki, H., Kawashima, M., Hongo, O., Yaoita, H., Ikeno, M. et al. Incidence of arthro-osteitis in patients with pustulosis palmaris et plantaris. Ann Rheum Dis 1981, 40, 554–557.

    PubMed  Google Scholar 

  60. Sutro, C.J., Sutro, W.H. Hyperostosis of the clavicle and ossification of the costoclavicular ligament in association with ankylosing spondylitis. Bull Hospital Joint Dis 1984, 44, 65–71.

    Google Scholar 

  61. Schilling, F., Fassbender, H.G., Stiehler, T. Spondarthritis hyperostotica pustulo-psoriatica. In: Arthritis und Spondylitis psoriatica. Ed: Schilling, F., Steinkopff, Darmstadt, 1986, pg. 289–296.

    Google Scholar 

  62. Uehlinger, E. Hyperostosis generalisata mit Pachýdermie. (Idiopathische familiäre generalisierte Osteophytose Friedreich-Erb-Arnold). Virchows Arch Pathol Anat 1942, 308, 396–444.

    Google Scholar 

  63. Ueno, K., Rikimaru, S., Kawashima, Y., Sakai, H. Bone imaging sternocostoclavicular hyperostosis in palmoplantar pustulosis. Clin Nucl Med 1986, 11, 420–425.

    PubMed  Google Scholar 

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  1. Röntgeninstitut, Allgemeines Krankenhaus, Barmbek, Rübenkamp 148, D-2000, Hamburg 60, Germany

    W. Dihlmann

  2. Department of Traumatic and Reconstructive Surgery, University of Hamburg, Germany

    S. W. Dihlmann

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Dihlmann, W., Dihlmann, S.W. Acquired hyperostosis syndrome: Spectrum of manifestations at the sternocostoclavicular region. Radiologic evaluation of 34 cases. Clin Rheumatol 10, 250–263 (1991). https://doi.org/10.1007/BF02208686

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