Pustulotic arthroosteitis: spectrum of bone lesions with palmoplantar pustulosis.

Abstract

To discuss the association of palmoplantar pustulosis (PPP) with sternocostoclavicular hyperostosis (SCCH) and other infection- or tumor-simulating bone lesions. From 1989 to 1992, 25 patients (11 men and 14 women, aged 19-69 years [mean, 42 years]) with pustulotic arthroosteitis (PAO) and SCCH were seen. Findings were accumulated to determine the concomitant findings of other bone lesions. Thirteen patients with skeletal lesions had proved PPP. Eleven of these patients also had SCCH, four had sacroiliitis, six had spondylitis, and six had tumorlike manifestations in the appendicular skeleton. In another 12 patients with SCCH, none had proved PPP but four had psoriasis. Fifteen of 25 patients with SCCH had skin disease. Seven of the 25 patients had only one site of bone involvement (six had SCCH and one had spondylitis); all other patients (including the six with tumor-simulating extraaxial lesions) had more than one skeletal site of bone involvement. Because radiologists play the key role in the diagnosis of PAO, awareness of the possibility of benign disease is necessary to obviate certain diagnostic or therapeutic procedures.