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Thorax
Published in Harold Ellis, Adrian Kendal Dixon, Bari M. Logan, David J. Bowden, Human Sectional Anatomy, 2017
Harold Ellis, Adrian Kendal Dixon, Bari M. Logan, David J. Bowden
The plane of this section traverses the lower part of the body of the sixth thoracic vertebra (24). Anteriorly, it passes through the body of the sternum (2) at the level of the third costal cartilage (1). Note the adjacent sternocostal joint. These vary; the first lacks a synovial cavity, its costal cartilage being attached by fibrocartilage to the manubrium.The second to seventh joints are usually synovial (as in this subject), with the fibrocartilaginous articular surfaces on both the chondral and the sternal components of the joint. In some or all of these joints, however, an arrangement may be found similar to that of the first joint.
Scleritis Associated with SAPHO Syndrome: A Case Report
Published in Ocular Immunology and Inflammation, 2018
Rie Tanaka, Keiichi Sakurai, Toshikatsu Kaburaki
A 31-year-old woman developed acute-onset painful red eyes for 3 weeks and was diagnosed with scleritis at a local ophthalmology clinic. The scleritis persisted, despite treatment with steroid eye drops. Therefore, she was admitted to our hospital. During her initial visit, her best-corrected visual acuity was 20/22 in each eye. Her intraocular pressure was normal, and a slit-lamp examination revealed bilateral anterior diffuse scleritis (Figure 1A). A funduscopic examination of the posterior segment was unremarkable. Her blood examination result revealed an abnormal erythrocyte sedimentation rate of 36 mm/h and a positive rheumatoid factor (39 IU/mL). Her C-reactive protein level was within normal limits (0.27 mg/dL). Her anticyclic citrullinated peptide antibody, antineutrophil cytoplasmic antibody, and antinuclear antibody titers were negative. Human leukocyte antigen (HLA) typing revealed A11, A31, and B39, but not A26, B27, or B51. She had been diagnosed with palmoplantar pustulosis by a dermatologist 2 years previously and now showed eruption of pustules on the palms of both hands (Figure 1B). She also reported anterior chest pain that persisted for 6 months. We referred her to a rheumatologist to rule out a possible systemic autoimmune disease. Detailed physical examinations by rheumatologists revealed tenderness of the right sternocostal joint, metatarsophalangeal joint, and distal interphalangeal joint of the right hand. A pelvic computed tomography scan revealed hyperostosis of the sacroiliac joint (Figure 1C). A technetium-99m hydroxymethylene diphosphonate scintiscan showed increased uptake of the radiotracer in the bilateral sternoclavicular and right sternocostal joints (Figure 1D). Inflammatory bowel disease was not found by gastrointestinal endoscopy. Thus, the patient was diagnosed with SAPHO syndrome by rheumatologists.