Palmoplantar pustulosis andsternocostoclavi cular arthro-osteitis

SUMMARY Seventeen patients withshoulder painandradiographic involvement ofthe sternoclavicular orsternocostal joints, orboth, aredescribed. Eleven ofthese patients also had palmoplantar pustulosis. Histological examination ofthejoints showedchronic andsubacute inflammation, increased osteoblastic activity, andcartilage degeneration. Propionibacterium acneswas cultured intissue samples fromsevenofthe15biopsied patients, afinding atvariance withthose ofprevious reports. Thepossibility that sternoclavicular arthro-osteitis isofinfectious origin should bethesubject offurther investigation. Non-steroidal anti-inflammatory drugs (NSAIDs) may provide painrelief, possibly owingtotheir inhibitory action on osteoblasts. In casesofseverely restricted movementor severepainresection ofthemedial clavicle may be considered.