Choi Min-Hee, Yoon In-Young, Kim Won-Joong
Department of Anesthesiology and Pain Medicine, Ewha Womans University Mokdong Hospital, Seoul 07985, South Korea.
World J Clin Cases. 2023 Mar 26;11(9):2043-2050. doi: 10.12998/wjcc.v11.i9.2043.
Manubriosternal joint (MSJ) disease is a rare cause of anterior chest pain but can be a major sign of systemic arthritic involvement. In patients with ankylosing spondylitis (AS), a type of systemic arthritis, chest pain can be due to MSJ involvement and can be improved by ultrasound-guided corticosteroid injection into the joint.
A 64-year-old man visited our pain clinic complaining of anterior chest pain. There were no abnormal findings on lateral sternum X-ray, but arthritic changes in the MSJ were observed on single-photon emission computed tomography-computed tomography. We performed additional laboratory tests, and he was finally diagnosed with AS. For pain relief, we performed ultrasound-guided intra-articular (IA) corticosteroid injections into the MSJ. After the injections, his pain nearly resolved.
For patients complaining of anterior chest pain, AS should be considered, and single-photon emission computed tomography-computed tomography can be helpful in diagnosis. In addition, ultrasound-guided IA corticosteroid injections may be effective for pain relief.
胸柄关节（MSJ）疾病是前胸疼痛的罕见病因，但可能是全身性关节炎累及的主要体征。在强直性脊柱炎（AS）患者中，这是一种全身性关节炎，胸痛可能是由于MSJ受累，通过超声引导下向关节内注射皮质类固醇可缓解疼痛。
一名64岁男性因前胸疼痛就诊于我们的疼痛诊所。侧位胸骨X线检查未见异常，但单光子发射计算机断层扫描-计算机断层扫描显示MSJ有关节炎改变。我们进行了进一步的实验室检查，最终他被诊断为AS。为缓解疼痛，我们对MSJ进行了超声引导下关节内（IA）皮质类固醇注射。注射后，他的疼痛几乎完全缓解。
对于主诉前胸疼痛的患者，应考虑AS，单光子发射计算机断层扫描-计算机断层扫描有助于诊断。此外，超声引导下IA皮质类固醇注射可能对缓解疼痛有效。
