How do you treat xiphoiditis?

Answer 1

Xiphoiditis is strongly associated with autoimmune processes, in fact 98% of cases of xiphoiditis are associated with an autoimmune disease. Other causes include radicular pain from a thoracic disc syndrome, osteomyelitis (bone infection), or a bony neoplasm (cancer), or soft tissue sarcoma (cancer).

Out of the autoimmune diseases, Ankylosing Spondylitis is most strongly associated with xiphoiditis, particularly if you are a male, followed by rheumatoid arthritis and psoriatic Arthritis, which together explain 75% of the cases. Less common is a form of scleroderma called diffuse systemic sclerosis which can also produce those symptoms, as well as mixed connective tissue disease, and lupus.

Typically anyone presenting with symptoms of persistent xiphoiditis should seek the advice of a rheumatologist, before any other medical specialty. At minimum, tests should include a technetium bone scan, and a set of X-rays of the chest, spine, and sacroiliac joints. An MRI is highly recommended as well. The bone scan will likely pick up sites of inflammation, infection, or possible neoplasms. A rheumatologist will likely be able to spot other signs of disease in your joints, even if the disease is at an early stage, and be able to tailor a treatment to your individual needs. If not, he will refer you to the appropriate medical specialty depending on your condition.

Treatment will likely consist of anti-inflammatories, followed by DMARDS (disease modifying rheumatic drugs) or corticosteroids.