Material from a 10-year retrospective study of 268 patients with seronegative arthritis was analyzed with regard to the frequency of radiographic anterior chest wall (ACW) joint or bone lesions. Changes of the sternoclavicular joint were found in 17% of patients with ankylosing spondylitis (AS), in 6-9% of patients with reactive and psoriatic arthritis, and in 48% of patients with arthritis associated with palmoplantar pustular (PPP) lesions. The manubriosternal joint (MSJ) was involved in 51-57% of patients with AS and PPP lesions as well as in 18-24% of patients with reactive and psoriatic arthritis. The presence of ACW involvement was significantly related in AS, reactive and PPP associated arthritis to the duration of the disease; in AS to advanced sacroilitis, and involvement of the spine and root joints; in psoriatic and reactive arthritis to the presence of peripheral erosive polyarthritis; in reactive arthritis to sacroiliitis and spondylitis; and in psoriatic arthritis to root joint involvement.