BACKGROUND Manubriosternal joint(MSJ)disease is a rare cause of anterior chest pain but can be a major sign of systemic arthritic involvement.In patients with ankylosing spondylitis(AS),a type of systemic arthritis,ch...BACKGROUND Manubriosternal joint(MSJ)disease is a rare cause of anterior chest pain but can be a major sign of systemic arthritic involvement.In patients with ankylosing spondylitis(AS),a type of systemic arthritis,chest pain can be due to MSJ involvement and can be improved by ultrasound-guided corticosteroid injection into the joint.CASE SUMMARY A 64-year-old man visited our pain clinic complaining of anterior chest pain.There were no abnormal findings on lateral sternum X-ray,but arthritic changes in the MSJ were observed on single-photon emission computed tomography-computed tomography.We performed additional laboratory tests,and he was finally diagnosed with AS.For pain relief,we performed ultrasound-guided intra-articular(IA)corticosteroid injections into the MSJ.After the injections,his pain nearly resolved.CONCLUSION For patients complaining of anterior chest pain,AS should be considered,and single-photon emission computed tomography-computed tomography can be helpful in diagnosis.In addition,ultrasound-guided IA corticosteroid injections may be effective for pain relief.展开更多
文摘BACKGROUND Manubriosternal joint(MSJ)disease is a rare cause of anterior chest pain but can be a major sign of systemic arthritic involvement.In patients with ankylosing spondylitis(AS),a type of systemic arthritis,chest pain can be due to MSJ involvement and can be improved by ultrasound-guided corticosteroid injection into the joint.CASE SUMMARY A 64-year-old man visited our pain clinic complaining of anterior chest pain.There were no abnormal findings on lateral sternum X-ray,but arthritic changes in the MSJ were observed on single-photon emission computed tomography-computed tomography.We performed additional laboratory tests,and he was finally diagnosed with AS.For pain relief,we performed ultrasound-guided intra-articular(IA)corticosteroid injections into the MSJ.After the injections,his pain nearly resolved.CONCLUSION For patients complaining of anterior chest pain,AS should be considered,and single-photon emission computed tomography-computed tomography can be helpful in diagnosis.In addition,ultrasound-guided IA corticosteroid injections may be effective for pain relief.
