PUSTULOTIC ARTHROOSTEITIS - SPECTRUM OF BONE-LESIONS WITH PALMOPLANTAR PUSTULOSIS

PURPOSE: To discuss the association of palmoplantar pustulosis (PPP) w ith sternocostoclavicular hyperostosis (SCCH) and other infection- or tumor-simulating bone lesions. MATERIALS AND METHODS: From 1989 to 199 2, 25 patients (11 men and 14 women, aged 19-69 years [mean, 42 years] ) with pustulotic arthroosteitis (PAO) and SCCH were seen. Findings we re accumulated to determine the concomitant findings of other bone les ions. RESULTS: Thirteen patients with skeletal lesions had proved PPP. Eleven of these patients also had SCCH, four had sacroiliitis, six ha d spondylitis, and six had tumorlike manifestations in the appendicula r skeleton. In another 12 patients with SCCH, none had proved PPP but four had psoriasis. Fifteen of 25 patients with SCCH had skin disease. Seven of the 25 patients had only one site of bone involvement (six h ad SCCH and one had spondylitis); all other patients (including the si x with tumor-simulating extraaxial lesions) had more than one skeletal site of bone involvement. CONCLUSION: Because radiologists play the k ey role in the diagnosis of PAO, awareness of the possibility of benig n disease is necessary to obviate certain diagnostic or therapeutic pr ocedures.