Sternoclavicular Rheumatoid Arthritis

Axial CT images of the sternoclavicular joints show erosion, indistinct cortical margins of the joints, which are quite symmetric.

Facts:

• Sternoclavicular (SC) joint is diarthrodial articulation between axial and appendicular skeleton, which is subject to same disease process that occur in other joints (degenerative arthritis, rheumatoid arthritis, infection and subluxation. Degenerative arthritis is the most common).
• Up to 30% of patients with rheumatoid arthritis have changes in SC joints (a part of polyarticular involvement) but radiographic findings are often unremarkable.

Imaging Finding

• Synovitis
• Bone marrow edema and enhancement of subcortical bone (after IV contrast)Er
• Erosion and indistinct cortical margins
• Think infection if: unilateral, history of IVDU and immunocompromised states

References:

1. Restrepo CS, Martinez S, Lemos DF, et al. Imaging appearance of the sternum and sternoclavicular joints. Radiographics 2009; 29:839-859.

2. Berry DJ, Steinmann SP. Adult Reconstruction, 2007.