Fluoroscopy-guided application of corticosteroids for local control of manubriosternal joint pain in patients with spondyloarthropathies.

Symptomatic manubriosternal arthritis, occasionally encountered with spondyloarthropathies, may not be adequately controlled by systemic therapy. Local corticosteroid injections make a potential contribution to symptomatic management. Three patients with acute inflammation of the joint as documented by MRI and fluoroscopy-guided therapy are presented. Topical treatment with triamcinolone acetonide (40 mg) was well tolerated and induced rapid and complete relief of pain for between 3 weeks and 3 months. In spite of the clinical improvement, the signs of inflammation in MRI did not decrease. Local steroid application seems to be an underused therapeutic modality in managing rheumatic involvement of the anterior chest wall.