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Letter
Large synovial cysts originating from the sternoclavicular joints in a patient with rheumatoid arthritis
  1. A P Andonopoulos1,
  2. N Meimaris1,
  3. G Yiannopoulos1,
  4. V Pastromas2,
  5. P Dimopoulos2
  1. 1Department of Medicine, Division of Rheumatology, University of Patras School of Medicine, Patras, Greece
  2. 2Department of Radiology, University of Patras School of Medicine, Patras, Greece
  1. Correspondence to:
    Professor A P Andonopoulos, Division of Rheumatology, University of Patras School of Medicine, 26 500 Rio, Patras, Greece;
    andandonmed.upatras.gr

https://doi.org/10.1136/ard.62.11.1119

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    Synovial cysts in rheumatoid arthritis (RA), most common in the popliteal fossa,1,2 have also been described in proximity to several other rheumatoid joints,3–9 but never the sternoclavicular joints.

    CASE REPORT

    We here describe, for the first time, the development of unusually large synovial cysts, from the disproportionately small sternoclavicular joints, in a 58 year old man, with a 27 year history of severe, seropositive, erosive, destructive, deforming, nodular RA. Over the years he had been treated, albeit erratically, with several disease modifying antirheumatic drugs (DMARDs), but he had been poorly followed up.

    Seven months ago, while receiving d-penicillamine 500 mg/day and methylprednisolone 2 mg/day, he presented with a 10 cm long and 5 cm thick, fluctuant, non-tender, sausage-like mass over the right clavicle, and a smaller one, about 5 cm …

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