case_images: PMC6676622_01
case_images: Fluorescein angiogram of the left eye demonstrating regions of retinal vascular staining and leakage near the optic nerve and in the peripheral retina (arrows)
case_images: 41927_2019_76_Fig1_HTML.jpg
case_images: PMC6676622_01_41927_2019_76_Fig1_HTML.jpg
case_images: Fig1
case_images: These findings were consistent with retinal vasculitis of both eyes (Fig. 1).
case_images: a Computed tomography (CT) scan of the thorax demonstrating sclerosis of sternum and manubrium with erosions of sternoclavicular joint. b Positron Emission Tomography - Computed Tomography (PET-CT) fusion images demonstrating multiple areas of abnormal hypermetabolism with diffuse uptake throughout the entire manubrium sternum with expansion of the manubrium and intense activity at the manubrial sternal junction. c Positron Emission Tomography (PET) demonstrating multiple abnormal regions of hypermetabolism corresponding with sclerotic and partially lytic lesions in the sternum and bilateral clavicular heads. Normal physiologic tracer uptake is present in the brain, heart, salivary and parotid glands, adenoids and palatine tonsils and vocal cords. There is also physiologic urinary clearance of the tracer into the renal collecting system
case_images: 41927_2019_76_Fig2_HTML.jpg
case_images: PMC6676622_01_41927_2019_76_Fig2_HTML.jpg
case_images: Fig2
case_images: Initial imaging at the time of the current presentation included plain chest X-ray (Fig. 2) which demonstrated expansion and sclerosis of the sternum most visible on the lateral view as well as swelling and erosions of the sternoclavicular joint. Posteriorly, inflammatory stranding extended into the anterior superior mediastinum with sub-centimeter anterior mediastinal lymph nodes present in greater number than typically seen, and a mildly enlarged left internal mammary lymph node measuring 1.1 cm (Fig. 2). Positron Emission Tomography and fusion Positon Emission Tomography-Computed Tomography (PET-CT) images demonstrated multiple areas of abnormal hypermetabolism with diffuse uptake throughout the entire manubrium sternum with expansion of the manubrium and intense activity at the manubrial sternal junction (Fig. 2).