The manubriosternal joint in rheumatoid disease.

Manubriosternal joint abnormalities are often undetected causes of chest pain. Twenty-five normal patients and 40 cadaver specimens were evaluated to establish the normal radiographic anatomy of this articulation. Analysis of the manubriosternal joint was carried out in rheumatoid diseases in order to ascertain the incidence and variety of abnormalities. Twenty-seven of 100 manubriosternal joints were abnormal in rheumatoid arthritis. Of 25 patients with ankylosing spondylitis 20 (80%) revealed abnormalities either with erosions or fusion. None of 25 patients with psoriatic arthritis and none of 20 with Reiter syndrome showed erosions or ankylosis. The articulation should be evaluated in rheumatoid diseases and in non-arthritic patients with chest and/or shoulder pain.