Soft tissue involvement, mediastinal pseudotumor, and venous thrombosis in pustulotic arthro-osteitis

A syndrome of hyperostosis of the thoracic wall, nonspecific signs of inflammatory disease, and palmar and plantar pustulosis is described in eight patients (Table 1). Seven had intersternocostoclavicular ossification [12], and one had chromic recurrent multifocal osteomyelitis [2]. This complex of findings has been called “pustulotic arthro-osteitis” [5, 12]. This report emphasizes the periosseous soft tissue inflammation and the unexplained subclavian and mediastinal vein thrombosis seen in two patients [8]. Inflammatory periosseous and mediastinal lesions were seen on plain films in all eight patients and on computed tomographic (CT) scans in seven. Radiographs of the spine showed a spondyloarthropathy in three patients. This was characterized by ossification of the vertebral ligaments and sclerosis of the vertebral bodies. Awareness of the radiologic features of pustulotic arthro-osteitis is important because the clinical, biochemical and pathologic findings are often nonspecific and misleading [5, 8, 12].Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/46791/1/256_2004_Article_BF00366761.pd

Evidence-based medicine in orthopaedics.

Evidence-based medicine (EBM) is medicine based on the sum of personal clinical experience and clinical studies with the best possible design (preferably, but not necessarily, randomised controlled trials or RCTs), while focusing on the expectancies of patients and institutions