COMPUTED-TOMOGRAPHY OF STERNOCLAVICULAR JOINT LESIONS IN SPONDYLARTHROPATHIES

To evaluate the computed tomography (CT) findings of inflammatory lesi ons of the sternoclavicular joints (SCJ) in spondylarthropathies. Desi gn and patients. CT scans of the SCJs were obtained in 23 patients (gr oup 1) with inflammatory SCJ lesions in spondylarthropathies. These sc ans were reviewed by four readers and compared with the CT scans of 23 matched controls (group 2). Each reader had to complete a 27-item gri d. Results and conclusion. In the 23 patients of group 1, the mean num ber of observed signs was 5.3+/-4.2 higher (P<0.01) than in the group of 23 matched controls (2.4+/-1.6). Four signs were more frequently ob served (P<0.05) in group 1: surrounded subchondral clavicular erosions and cysts, surrounded subchondral sternal cysts and sternal bone scle rosis. A cyst and/or an erosion was associated with hyperostosis and/o r bone sclerosis in 9 of 23 patients in group 1. This association was not observed in group 2; the difference was significant (P<0.001). A c yst and/or an erosive lesion was observed 18 times in group 1 versus 1 1 times in group 2; the difference was significant (P<0.05). Conversel y, signs of degenerative lesions (osteophytes, subchondral sclerosis, unevenness of joint surface) were no more frequently observed in contr ols than in group 1. This study emphasizes the diagnostic value of CT, in particular in the identification of inflammatory lesions, even whe n pre-existing degenerative disease is present.