Imaging of the seronegative anterior chest wall (ACW) syndromes

Abstract

The sternocostoclavicular (SCC) region is subject to the same diseases that occur in joints, with congenital and developmental anomalies, inflammatory and infectious diseases, soft tissue and bone tumors as well as the seronegative spondyloarthropathies, including ankylosing spondylitis, reactive arthritis, enteropathic arthritis, psoriatic arthritis, pustulosis palmoplantaris and other syndromes. Most of these conditions present with swelling of the joint, which may be associated with pain and/or tenderness. These disorders are characterised by onset usually before the age of 40 years, absence of serum autoantibodies and sometimes the association with antigen human leukocyte antigen B27. Traditional X-ray study is indicated in the initial evaluation of SCC joint disorders, but other imaging modalities typically are often necessary to clarify the pathology. Computed axial tomography scans are indicated for disease processes in which bony destruction or ossification may occur. Magnetic resonance imaging provides more detailed and useful information when evaluating suspected pathology involving inflammation or soft tissue mass. Bone scintigraphy can help to correlate active inflammation of the SCC joint with symptoms of pain. The purpose of this study is to introduce the clinical and radiological aspects of the seronegative anterior chest wall diseases, particularly the contribution of the different imaging techniques.