Clinical and Histological Features of Pustulotic Arthro-osteitis: Experience of 17 Cases

DOI
  • YAYAMA Takafumi
    Department of Orthopaedic Surgery, Fukui University Faculty of Medicine
  • UCHIDA Kenzo
    Department of Orthopaedic Surgery, Fukui University Faculty of Medicine
  • KOBAYASHI Shigeru
    Department of Orthopaedic Surgery, Fukui University Faculty of Medicine
  • SATO Ryuichiro
    Department of Orthopaedic Surgery, Fukui University Faculty of Medicine
  • BABA Hisatoshi
    Department of Orthopaedic Surgery, Fukui University Faculty of Medicine

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We describe the clinical features of 17 patients with pustulotic arthro-osteitis (PAO), all having the typical skin rash of palmoplantar pustulosis (PPP) and osteitis. Arthro-osteitis with intersterno-costoclavicular or manubriosternal lesions was observed in all 17 cases. Osteitis was also seen in spinal, sacroiliac, and peripheral joints. The majority of osteo-arthritis was monoarthritic or oligoarthritic in type. Polyarthritis resembled rheumatoid arthritis in some cases, but the arthritis was asymmetrical, and followed a monocyclic course. Bone and joint lesions followed a variable and intermittent clinical course over an extended period. Histological examination revealed similar inflammatory changes in skin and bone lesions, with infiltration by lymphocytes and polymorphonuclear leucocytes. These results suggested that PPP and PAO have common aetiological factors.

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