Septic arthritis of the sternoclavicular joint in healthy adults

Abstract

Septic arthritis of the sternoclavicular joint (SCJ) is a rare disorder, and is usually associated with predisposing factors such as contiguous foci of infection, heroin addiction, rheumatoid arthritis and diabetes mellitus. Three cases in previously healthy adults are reported here. The aetiology, clinical manifestations and treatment are briefly reviewed. The considerable difficulty in diagnosing this disorder in adults is emphasized. In summary, diagnosis of septic arthritis of the SCJ in adults requires a high index of suspicion, and must be considered not only in patients with predisposing factors, but also in previously healthy adults.

Spiral CT with multiplanar reconstruction in the diagnosis of sternoclavicular osteomyelitis

“…Radiation, surgery (particularly median sternotomy), trauma, and steroid use also predispose to sternoclavicular septic arthritis [1,5,8]. Interestingly, this arthritis has also been reported in healthy adults with no significant medical history [11].…”

“…Primary bone tumors should be considered in the appropriate setting, including osteoid osteoma, myeloma, chondrosarcoma, and malignant synovioma [14]. Tumors which may metastasize to this region include thyroid, renal, prostate, neck tumors, and lymphoma [ 11,14]. Homoradical neck dissection may cause sternoclavicular changes mimicking osteomyelitis clinically and radiographically; however, patients respond to anti-inflammatory medications [14].…”

Unusual clinical presentations of brucellosis in childhood

“…The other bacterial agents, especially Brucella spp., are less likely to be involved. 5 Clinical presentation is often sudden, and patients might complain for days to months of atraumatic pain in the shoulder, neck or chest, with limited motion of the upper extremities, and associated fever. The diagnosis of the SCJ infection is therefore difficult.…”

Chronic Sternoclavicular Osteomyelitis: Salvage Surgery With Internal Mammary Artery Perforator Flap

“…It is associated with a series of predisposing factors, such as rheumatoid arthritis, diabetes, immunosuppressant therapies, intravenous drug addiction, previous joint trauma, head and neck surgery, and subclavian vein catheterization. 3 To reach a definitive diagnosis, however, it is necessary to culture the microorganism involved in the bone fragment, joint fluid, or blood culture. Septic arthritis due to gram-negative germs, as in the case of our patient, are less common and usually appear in patients with chronic diseases that weaken the immune system, such as diabetes mellitus, cirrhosis of the liver and cancer.…”