Association of Tietze's syndrome and arthritis of manubriosternal and sternoclavicular joints with pustular bacterid (pustulosis palmaris et plantaris due to focal infection)

Abstract

Painful orthopedic symptoms in the sternal area such as arthritis of the manubriosternal joint (5 cases) and sternoclavicular joint (4 cases), and Tietze's syndrome (4 cases) were found in 14 of 132 cases of pustulosis palmaris et plantaris. Majority of pustulosis palmaris et plantaris patients with orthopedic symptoms had the skin eruptions not only in the palms and soles, but also in the backs of the hands and feet, the arms, the legs and the trunk. Such cases tended to show elevation of erythrocyte sedimentation rate, leucocytosis, changes of serum globulin, and also pyrexia at the time of exacerbation. The skin and orthopedic symptoms often worsened after acute exacerbation of focal infection, and occasionally responded to tonsillectomy or chemotherapy with antibiotics, suggesting the probable cause of bacterid.