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Sternoclavicular infectious arthritis in previously healthy adults
Michal Bar-Natan1, Moshe Salai, Yechezkel Sidi
1Department of Medicine C and Orthopedics and the Rheumatology Unit, The Chaim Sheba Medical Center, Tel Hashomer; and the Sackler Faculty of Medicine, Tel Aviv University, Israel.
Objective:
To define characteristics of sternoclavicular infection (SCI) in previously healthy patients.
Methods:
SCI in a previously healthy man is reported along with 4 similar cases found by surveying the hospital's database; 22 previously reported cases were culled from the literature and summarized.
Results:
The frequency of SCI in healthy adults was 0.5% of all bone and joint infections admitted to the hospital. The clinical and bacteriologic features were similar to previous reports in nonselected SCI patients. Computerized tomography (CT) scan, arthrocenthesis, and biopsy were required for diagnosis. Complications included abscess formation, mediastinitis, and sepsis. The majority of patients were treated by surgical drainage and antibiotics. The final outcome was good, without mortality or long-term morbidity.
Conclusions:
Although SCI is a rare infection in healthy adults, it should be considered in the differential diagnosis of a painful sternoclavicular joint. Prompt diagnosis and appropriate treatment of SCI results in excellent outcome in most cases.