Unilateral sternocostoclavicular hyperostosis in a patient with ankylosing spondylitis: A case report with color Doppler ultrasonogram findings
A 42-year-old male attended our Rheumatology outpatient clinic with a history of swelling and mild pain of right SCJ for about eight months. There was no history of trauma or fever. The patient had been diagnosed to have ankylosing spondylitis since ten years with predominantly axial involvement. Clinical examination revealed a warm, hard and tender swelling over right SCJ. No skin lesions such as acne or pustulosis palmaris et plantaris were observed. Ankylosing spondylitis disease activity was fairly controlled (Bath ankylosing spondylitis disease activity index: 2.5.[] Radiograph of sternoclavicular joint did not detect any abnormality. Ultrasonography (USG) and doppler examination revealed calcifications around the joint with periarticular hypervascularity [Figures and ]. Doppler spectral analysis revealed low-resistance flow []. All the features were compared with normal left SCJ. CT scan showed calcifications around the right sternoclavicular joint and adjacent right first rib []. A diagnosis of right SCCH was made from clinical and imaging features. The patient was treated with non-steroidal anti-inflammatory agent and advised rest, physiotherapy and follow-up.