Die pustulöse Arthro-Osteitis - Modell einer reaktiven Spondarthritis?

Abstract

Pustulotic arthro-osteitis exemplifies the fact that the catalogue of nosological entities is by no means complete even in rheumatology and that individual symptoms are being recorded by various authors of different disciplines at different times, independent of each other, resulting in a jig-saw puzzle of individual observations that may take years to fit together. As far as pustulotic arthro-osteitis is concerned, it is a particularly unusual and fascinating fact that this disease appears to be a combination of palmo-plantar pustulosis, sternoclavicular hyperostosis and a variety of other skeletal changes plus tangential connections to other (related?) diseases. There are some pointers indicating that it is a reactive spondylarthropathy that is identical with chronic multifocal osteomyelitis occurring in childhood and adolescence. It is interesting to note that very similar arthritic changes have been seen in the course of adjuvant arthritis in the rat where T-lymphocytes were employed. In this particular phenomenon in the rat an abacterial (in this case probably immunologically mediated by the T-lymphocytes) chronic hyperostotic osteomyelitis may also occur.