[Clinical and radiological study of the manubrio-sternal articulation. Comparison between 80 control subjects and 88 patients with chronic inflammatory rheumatism].

The manubrio-sternal joint was studied in 168 subjects divided up into two groups : one group of 80 control subjects and one group of 88 patients with chronic inflammatory rheumatism divided up into 3 sub-groups (rheumatoid arthritis 54 ; ankylosing spondylitis 25 ; peripheral psoriatic rheumatism 9). This was a clinical study (search for spontaneous and induced pain) and a radiological study (A.P. and lateral views) with classification in 5 groups : 0 normal appearance, 1 hazy appearance of the joint space, slight narrowing of the joint space, slight osteoporosis and/or subchondral bony condensation ; 2 irregularity of the margins of the joint space, increased osteoporosis and/or condensation, narrowing of the joint space ; 3 increase in the previous signs, erosion, vacuole formation ; 4 partial or total fusion. The results show that only spontaneous pain and the radiological appearances of class II and class III permit one to differentiate in a statistically significant way the control group from the rheumatism group. considering these data one may note a greater frequency of the clinical and radiological signs, together with greater clinical and radiological agreement in ankylosing spondylitis than in rheumatoid arthritis. The interest of a study of the manubrio-sternal joint in the early diagnosis of ankylosing spondylitis is recalled although the involvement of this joint is usually later than the sacro-iliac joint.