Serous synovitis of the sternoclavicular joint. Differential diagnostic aspects

Ten patients with unilateral spontaneous swelling of the sternoclavicular joint are presented. Plain radiographic examination of the joints revealed no abnormalities. Technetium scintigraphy was positive. After surgical biopsy the swelling and the symptoms disappeared. Patho-anatomical examination of synovialis from these joints revealed serous synovitis as the only pathological finding. Seven other patients with clinical symptoms undistinguishable from the above-mentioned and with normal plain radiographic findings showed, patho-anatomically: osteomyelitis (2 cases), ganglion (2 cases), osteoarthritis (1 case), Friedrich's disease (1 case) and a carcinoma metastasis (1 case). In view of the differential diagnostic aspects it was concluded that diagnosis of spontaneous swelling of the sternoclavicular joint after inconclusive serological, radiographical and scintigraphical examination, always should be established on the basis of surgical biopsy and patho-anatomical evaluation.