Isolated lesions of the manubriosternal joint in patients with inflammatory back pain and negative sacroiliac and spinal radiographs.

The prevalence of radiological lesions of the manubriosternal joint was assessed in 151 patients with chronic inflammatory back pain and in 31 controls with non-inflammatory back pain. Nineteen out of these 151 patients and none of the controls showed unequivocal lesions of the manubriosternal joint without accompanying radiological lesions of the sacroiliac joints or the lumbar spine. Thoracic pain and stiffness were present in 7 out of the 19 patients and in 3 out of the 31 controls (P less than 0.05); peripheral enthesopathy was present in 10 out of the 19 patients and in 4 out of the 31 controls (P less than 0.01); none of the patients or controls had rheumatoid factor, subcutaneous nodules, or peripheral arthritis. The suggestion of a "manubriosternal joint syndrome" is warranted by these findings.