Today, one of our patients with
ankylosing spondylitis visited us. He described a swelling of the sternum,
which had developed during the last four days. I palpated a swelling in the upper
part of the sternum, where manubrium sterni (handle) and corpus sterni (body)
meet, right in the middle. Therefore, an inflammation of a costo-sternal joint could
already be excluded.
A bony change was not to be expected,
but could also be excluded by the X-ray of the lateral thorax, which was made
for another reason.
The ultrasound examination revealed a
roundish elevation above the manubriosternal symphysis of about 4 mm in diameter.
Neo-vasculization could be shown in the color coded Doppler examination
In summary, the swelling is a
symphysitis manubriosternalis. This is a rare manifestation in patients with
ankylosing spondylitis.
If one looks long enough at the manubriosternal symphysis, one may get the idea of a soft tissue swelling ...
The ultrasound picture, however, shows a swelling
The color coded Doppler in B/W print-out
shows neo-vasculization
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