A Clinical Study of the Osteo-arthropathy in Palmoplantar Pustulosis

Jang, Ho Sun; Seo, Kyung Hyung; Kwon, Kyung Sool; Chung, Tae Ahn; Oh, Chang Keun

Abstract

BACKGROUND: Palmoplantar pustulosis(PPP) is often associated with osteo-arthropathy, especially sternocostoclavicular hyperostosis(SCCH). The relation between PPP and SCCH or other types of seronegative arthropathy remains unclear.
OBJECTIVE
The purpose of this study was to investigate the distribution and the frequency of osteo-arthropathy in patients with PPP.
METHODS
Twenty fiv patients with PPP were included in this study, and checked for clinical symptoms and signs, labiratory findings, and radiologic findings including plain X-ray, 99mTc-MDP bone scan, and computed tomography.
RESULTS
The incidenc of osteo-arthropathy in PPP was 64%. The prevalent age at onset of osteo arthropathy was the forth decade in males, and the sixth decade in females. The frequent, sites of osteo arthralgia were sternocostoclavicular areas, spines, shoulders, knees, and sacroiliac joints, and the frequent sites of increased radioisotope uptake were similar to t,he distribution of sites of osteoarthropathy. 99mTc-MDP bone scan was more sensitive in detecting osteo-arthropathy than plain X ray and commputed tomography. In laboratory findings, we observed an increase in the erythrocyte sedimentation rate, leukocyte counts, alkaine phosphatase, and the positivity of C-reactive pr otein.
CONCLUSIONS
The frequent involvement of the anterior chest, wall, knees, spines, and sacroiliac joints was noted in patients with PPP. 99mTc MDP bone scan may be the most helpful in making a diagnosis of osteo-arthropathy accompanied with PPP.