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Chronic osteomyelitis of the clavicle
M S Granick1, S S Ramasastry, M A Goodman
1University of Pittsburgh Affiliated Plastic Surgery Program, Pa.
Plastic and Reconstructive Surgery
|July 1, 1989
Summary
Osteomyelitis of the clavicle is rare but important to consider with sternoclavicular pain after surgery or immunosuppression. Early diagnosis and aggressive surgical debridement with antibiotics are key for treatment.
Area of Science:
- Orthopedics
- Infectious Diseases
Background:
- Osteomyelitis of the clavicle is an uncommon condition.
- It can present secondary to procedures like head and neck surgery, irradiation, or subclavian vein catheterization, or in immunosuppressed patients.
- Idiopathic cases can also occur.
Observation:
- Clinical presentation may include pain, cellulitis, or drainage in the sternoclavicular area.
- Radiographic findings can mimic fractures or neoplasms on plain X-rays.
- Advanced imaging like CT scans and technetium-99m bone scans aid in diagnosis.
Findings:
- Secondary osteomyelitis of the clavicle is rare, unlike primary forms seen in children.
- Misdiagnosis is common due to similarities with other conditions on initial imaging.
- Definitive diagnosis often requires advanced imaging techniques.
Implications:
- Prompt recognition and consideration of clavicular osteomyelitis are crucial in at-risk patients.
- Aggressive surgical debridement of all affected tissues is essential for treatment.
- Combined surgical intervention with perioperative antibiotics and flap coverage offers the best outcomes.