OCAD MSK

History

39M left medial clavicle pain with 5 yrs intermittent multifocal pain

Figure 1 for case manubrium ( RID2476 ) — Figure 1

Figure 2 for case manubrium ( RID2476 ) — Figure 2

Figure 3 for case manubrium ( RID2476 ) — Figure 3

Discussion

The referrer ordered MRI of each clavicle, but the left side included the manubrium and upper sternum as well at the medial right clavicle. Symptoms are only near the left sternoclavicular joint. There are bilateral bright foci in the articular cartilage of the medial clavicle (white arrows), with subtle subchondral erosion but no BME on the left. There is left sided subchondral edema at the costomanubrial junction (yellow arrows). Obvious erosion with edema at the manubriosternal articulation The referrer did not notice any rash, though it sounds like he didnt think to look. Im thinking SAPHO and seronegative spondyloarthropathies; agree or not? The orthopedist says he will refer him to rheumatologist and will get me follow up when available. Reference article.

Diagnosis

manubrium ( RID2476 )

Hilary Umans, MD

Courtesy

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