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1/25. Sterno-costo-clavicular hyperostosis.

    Sterno-costo-clavicular hyperostosis (SCCH) is a condition of unknown aetiology in which a chronic inflammatory osteitis affects predominantly the medical clavicle, sternum and distal tibia and femur, sometimes associated with skin disease. We report on two patients with the typical bony lesions of SCCH and no associated skin disease.
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ranking = 1
keywords = hyperostosis
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2/25. Sternocostoclavicular hyperostosis. Presentation and long-term follow-up of three cases.

    Sternocostoclavicular hyperostosis is a rare disease characterized by recurrent pain and skeletal swelling in the upper part of the chest. The clinical manifestations are closely linked to pustulosis palmo-plantaris but the etiology is still obscure. We present three cases of sternocostoclavicular hyperostosis with a follow-up period of 9-22 years at our department.
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ranking = 66.509300572467
keywords = sternocostoclavicular, sternocostoclavicular hyperostosis, hyperostosis
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3/25. Stress fracture of the clavicle associated with sternocostoclavicular hyperostosis.

    We report a case of stress fracture of the clavicle associated with sternocostoclavicular hyperostosis. A 60-year-old man sustained a stress fracture of the right clavicle with no history of trauma. On radiography, hyperostosis of the anterior chest wall and ankylosis of the sternoclavicular joint were evident in addition to the fracture. fracture healing was uneventful after 2.5 months. ankylosis of the sternoclavicular joint may have caused increased stress at the midshaft of the clavicle by daily activity or minor trauma. Such a fracture is a rare complication of sternocostoclavicular hyperostosis.
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ranking = 393.2558034348
keywords = sternocostoclavicular, sternocostoclavicular hyperostosis, hyperostosis
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4/25. Rapid pain relief and remission of sternocostoclavicular hyperostosis after intravenous ibandronate therapy.

    Sternocostoclavicular hyperostosis (SCCH) is an infrequent but painful, localized disturbance of bone metabolism of unknown etiology. The diagnosis of SCCH is generally one of exclusion, and it is therefore frequently missed or delayed, leaving patients with pain that frequently fails to respond to standard analgesic therapy. Consequently, SCCH leads to significantly impaired quality of life. Characteristic increased localized bone turnover and inflammatory osteitis provide a strong rationale for using intravenous bisphosphonates to treat the condition. We report on three patients with long-standing, treatment-refractory SCCH in whom intravenous ibandronate injections (a single administration of 4 mg followed by 2 mg every 3 months for up to a year) produced prompt, dramatic, persistent pain relief and resolution of the other symptoms of the disease. We also review recent evidence suggesting that SCCH is more common than generally believed and that technetium-99 bone scanning can aid in making an accurate diagnosis.
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ranking = 262.23720228987
keywords = sternocostoclavicular, sternocostoclavicular hyperostosis, hyperostosis
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5/25. In SAPHO syndrome anti-TNF-alpha therapy may induce persistent amelioration of osteoarticular complaints, but may exacerbate cutaneous manifestations.

    OBJECTIVES: SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis and osteitis) is a rare disease combining skin, bone and joint manifestations. In recent years new therapeutic strategies have been tried, among them TNF-alpha-blocking agents. We report our experience with infliximab in four cases of SAPHO syndrome refractory to conventional therapies. methods: Between 2002 and 2005, four cases of SAPHO syndrome (two females and two males; mean age 49.7 yr) responding poorly to conventional drugs were treated with infliximab. The dose was 5 mg/kg, according to the protocol used in spondyloarthropathies, with infusions at 0, 2 and 6 weeks followed by 6 weeks intervals. No active cutaneous manifestations were present at the time of starting therapy. RESULTS: Complete remission of osteoarticular involvement was achieved after the second or third infusion, and the positive response was maintained for up to 12 months. A patient relapsed after discontinuation of infliximab, because of infectious complication. Palmoplantaris pustulosis relapsed in two patients after three and six infusions, respectively; there was slight improvement after discontinuation of anti-TNF-alpha drugs. CONCLUSIONS: Infliximab seems to be a very effective therapy for osteoarticular complaints of SAPHO syndrome. Cutaneous involvement responded less favourably, palmoplantaris pustulosis relapse being a possible complication.
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ranking = 0.2
keywords = hyperostosis
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6/25. calcitonin treatment for intersternocostoclavicular ossification: clinical experience in two cases.

    Intersternocostoclavicular ossification is a benign arthro-osteitis of the upper anterior chest of unknown cause. Two patients with acute exacerbation of this disorder were successfully treated with intramuscular injections of an eel calcitonin analogue (40 units three times a week). Besides symptomatic relief of local pain and swelling, serial scintigrams showed quantitative improvement in radiophosphonate uptake. The rapid alleviation of pain implies that the hormone has a central analgesic effect, in addition to its direct influence on bone cells and antiinflammatory action. In one patient the disease was associated with palmoplantar pustulosis, which was cured with oral colchicine, whereas the other patient did not have such skin lesions. Despite a hypothetical link between palmoplantar pustulosis and intersternocostoclavicular ossification, colchicine had no beneficial impact on the bone pain. salmon calcitonin delivered by nasal spray was tried for the second patient but failed, probably because of insufficient drug delivery. The initial favourable results described here warrant future use of calcitonin injection on a larger number of patients with intersternocostoclavicular ossification.
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ranking = 258.79556616539
keywords = sternocostoclavicular
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7/25. Pustular osteoarthropathy and its differential diagnosis.

    A combination of costo-sterno-clavicular hyperostosis and palmo-plantar pustulosis, sometimes with hyperostotic spondylosis and spondylarthritis, is called pustular osteoarthropathy. In the Western hemisphere 40 cases have been reported and in the far east the condition occurs more commonly. Five cases are described. diagnosis is difficult because the skin lesions can occur before the costo-sterno-clavicular hyperostoses. The clinical condition is discussed together with the differential diagnosis. Pustular osteoarthropathy seems to be an enthesopathy and the palmoplantar pustulosis is interpreted as a form of psoriasis.
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ranking = 0.2
keywords = hyperostosis
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8/25. Sternocostoclavicular hyperostosis: two cases with differing dermatologic syndromes.

    Sternocostoclavicular hyperostosis is a rare rheumatic condition characterized by ossification and erosion of the clavicle and the first rib, that has been shown to be associated with pustular skin lesions. We present 2 cases, one of which had features of pustulosis palmaris et plantaris and the other dissecting cellulitis of the scalp. Although the dermatologic manifestations differ, both cases have rheumatologic and roentgenographic features diagnostic of sternocostoclavicular hyperostosis.
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ranking = 66.509300572467
keywords = sternocostoclavicular, sternocostoclavicular hyperostosis, hyperostosis
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9/25. MR appearance of sternal hyperostosis.

    Sternal hyperostosis is characterized by prominent new bone formation and fibrosis with less pronounced areas of granulation tissue and round cell infiltration. In previously reported cases the process involved not only the sternum but adjacent bony areas as well. Depending upon the extent of disease, acquiring biopsy material for histologic analysis can be difficult. We report a case of sternal hyperostosis involving the sternum exclusively and extensively. magnetic resonance imaging was useful in directing biopsy for optimal histologic yield. This unusual case of sternal hyperostosis is believed to be the result of an inflammatory process.
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ranking = 1.4
keywords = hyperostosis
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10/25. Spinal changes in association with sternocostoclavicular hyperostosis.

    A case of sternocostoclavicular hyperostosis was reported in a 63-year-old woman who had been followed for 15 years. Radiographic changes in the claviculo-sternal area were typical of this condition, and biopsy revealed abnormalities in the right clavicle and in the sternum compatible with infection. Radiographic changes in the thoracic and lumbar spine revealed findings compatible with infective spondylitis and a seronegative spondylarthropathy, respectively. The nature of these spinal changes as compared with those of diffuse idiopathic skeletal hyperostosis and seronegative spondylarthropathy is discussed.
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ranking = 327.74650286234
keywords = sternocostoclavicular, sternocostoclavicular hyperostosis, hyperostosis
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