Sternoclavicular joint tuberculosis: A series of conservatively managed sixteen cases

Sternoclavicular joint tuberculosis is rare with non-specific signs and symptoms thus making correct clinical diagnosis difficult. Delay in diagnosis results in destruction of osteo-ligamentous structures, spread of abscess to deeper planes as well as bursting through skin resulting in joint instability and scar formation.

All the cases of sternoclavicular joint tuberculosis presented to the orthopaedic outdoor between 2004 and 2017 were evaluated clinico-radiologically along with cyto-histopathological and/or microbiological tests to ascertain the diagnosis before initiation of treatment.

There were 11 males and 5 females patients aged 11-65 years (mean, 35 years). Aspiration or curettage of the swelling was performed, and the diagnosis was confirmed in 12 cases by cytology, AFB stain, TB polymerase chain reaction, culture or a combination of these. In 4 patients, anti-tubercular treatment was initiated on clinical suspicion.

Diagnosing sternoclavicular tuberculosis requires multimodal approach. A strong clinical suspicion is required as the presentation is often atypical. Early detection of disease and with conservative treatment resulted in complete remission and minimal long term disability.