Psoriatic arthritis affecting the manubriosternal join

Manubriosternal synovitis in the absence of peripheral arthritis or spondylitis, in a patient with pustular psoriasis, is described. The radiologic changes noted on lateral chest radiograph consisted of erosions, sclerosis, and joint space widening. This coincidence of manubriosternal joint arthritis and pustular psoriasis is unusual in western populations.