Acute staphylococcal osteomyelitis of the clavicle

Osteomyelitis of the clavicle is a rare condition that is difficult to diagnose. We have reviewed five cases of acute staphylococcal osteomyelitis of the clavicle that have been collected over a 3-year period in our center. All patients had pain, fever, and swelling over the clavicle. All had a raised erythrocyte sedimentation rate with positive Staphylococcus aureus blood cultures at presentation. Three of our five patients required surgical drainage. Two of these patients had pathologic fracture of the clavicle while receiving treatment and then went on to develop complete resorption of the medial clavicle. Isolated reports of acute staphylococcal osteomyelitis of the clavicle in children occur in the literature. This behaves very differently from chronic sclerosing osteomyelitis and tuberculous osteomyelitis of the clavicle, which are more commonly reported. Our impression is that early treatment with high-dose intravenous antistaphylococcal antibiotics helps avoid the complication of pathologic fracture. The functional result after resorption of the medial clavicle is very good in the short term.