Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 26, 2023; 11(9): 2043-2050
Published online Mar 26, 2023. doi: 10.12998/wjcc.v11.i9.2043
Ultrasound-guided intra-articular corticosteroid injection in a patient with manubriosternal joint involvement of ankylosing spondylitis: A case report
Min-Hee Choi, In-Young Yoon, Won-Joong Kim
Min-Hee Choi, In-Young Yoon, Won-Joong Kim, Department of Anesthesiology and Pain Medicine, Ewha Womans University Mokdong Hospital, Seoul 07985, South Korea
Author contributions: Choi MH contributed to manuscript writing and editing; Yoon IY examined the patient and contributed to data analysis; Kim WJ contributed to conceptualization and supervision; All authors have read and approved the final manuscript.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read CARE Checklist (2016), and the manuscript was prepared and revised according to CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Won-Joong Kim, MD, PhD, Associate Professor, Department of Anesthesiology and Pain Medicine, Ewha Womans University Mokdong Hospital, 1071, Anyangcheon-ro, Yangcheon-gu, Seoul 07985, South Korea. ickypoo@naver.com
Received: November 25, 2022
Peer-review started: November 25, 2022
First decision: December 19, 2022
Revised: December 28, 2022
Accepted: February 15, 2023
Article in press: February 15, 2023
Published online: March 26, 2023
Processing time: 112 Days and 2.5 Hours
Abstract
BACKGROUND

Manubriosternal joint (MSJ) disease is a rare cause of anterior chest pain but can be a major sign of systemic arthritic involvement. In patients with ankylosing spondylitis (AS), a type of systemic arthritis, chest pain can be due to MSJ involvement and can be improved by ultrasound-guided corticosteroid injection into the joint.

CASE SUMMARY

A 64-year-old man visited our pain clinic complaining of anterior chest pain. There were no abnormal findings on lateral sternum X-ray, but arthritic changes in the MSJ were observed on single-photon emission computed tomography-computed tomography. We performed additional laboratory tests, and he was finally diagnosed with AS. For pain relief, we performed ultrasound-guided intra-articular (IA) corticosteroid injections into the MSJ. After the injections, his pain nearly resolved.

CONCLUSION

For patients complaining of anterior chest pain, AS should be considered, and single-photon emission computed tomography-computed tomography can be helpful in diagnosis. In addition, ultrasound-guided IA corticosteroid injections may be effective for pain relief.

Keywords: Ankylosing spondylitis; Anterior chest pain; Manubriosternal joint; Single-photon emission computed tomography-computed tomography; Case report

Core Tip: Manubriosternal joint (MSJ) disease is a rare cause of anterior chest pain but can be a major sign of systemic arthritic involvement. In patients with anterior chest pain, systemic arthritic diseases such as ankylosing spondylitis should be considered but are difficult to diagnose. This report suggests that single-photon emission computed tomography-computed tomography can be an effective diagnostic tool for evaluating musculoskeletal causes of anterior chest pain, and this pain can be controlled by ultrasound-guided intra-articular corticosteroid injections into the MSJ.