Arthritis Of Sternoclavicular Joint Research Articles

Pyogenic arthritis of sternoclavicular joint with negative pressure wound therapy following surgical resecton of the joint: a report of two cases

Pyogenic arthritis of sternoclavicular joint with negative pressure wound therapy following surgical resecton of the joint: a report of two cases

The Effect of Hormone Replacement Therapy on Postmenopausal Sternoclavicular Joint Arthritis

The Effect of Hormone Replacement Therapy on Postmenopausal Sternoclavicular Joint Arthritis

Multimodal imaging findings of SAPHO syndrome with no skin lesions: A report of three cases and review of the literature.

Synovitis, acne, palmoplantar pustulosis, hyperostosis and osteitis syndrome (SAPHO) is a rare syndrome that affects the skin, bones and joints. Diagnosis of SAPHO syndrome is established on clinical appearance and imaging features. The present case report described the imaging features of three cases of SAPHO with sternoclavicular joint arthritis but without skin manifestations using multiple imaging modalities, including computed tomography (CT), magnetic resonance imaging (MRI) and bone scintigraphy. The first case was a 52-year-old male who suffered from progressive sternoclavicular arthritis for 2 years. The second case was a 62-year-old female with arthritis in the larger joints for 5 years, particularly on the right thoracic area. The third case was a 44-year-old male who exhibited a slight bulge accompanied by pain in the upper anterior chest wall for 4 years. All of them lacked cutaneous lesions. CT demonstrated sclerosis and hyperostosis with subchondral erosions in the sternocostoclavicular joints. MRI revealed bone marrow edema that was slightly hypointense on T1-weighted imaging, and hyperintense on T2-weighted imaging. Typical 'bull head' signs were observed in bone scintigraphy images. The present case study demonstrated that SAPHO syndrome should be suspected in patients with multifocal osteitis or arthritis affecting the chest wall that lack skin manifestations. Multimodal imaging modalities in combination are helpful for SAPHO diagnosis.

Septic sternoclavicular arthritis, osteomyelitis and mediastinitis

Abstract Background Septic arthritis in the sternoclavicular joint (SCJ) is uncommon. Early diagnosis is difficult because of its insidious onset and lack of a radiological reference standard. In addition to joint destruction and dysfunction, delayed diagnosis and treatment may result in additional expansion of infection, sepsis, and mortality. Case Report We present a previously healthy 38-year-old man who presented after 10 days of fever and painful swelling on the upper chest. Septic sternoclavicular arthritis and mediastinitis were diagnosed and treated by parenteral antibiotics and staged surgery. The range of motion in the right shoulder completely returned; however, mild weakness of the right shoulder remained. Conclusion In patients presenting with upper chest, neck, or shoulder pain, physicians should include SCJ arthritis as a differential diagnosis. Multiple imaging examinations are often needed to reach a diagnosis. In septic SCJ arthritis, early institution of appropriate antibiotics is important, and surgical interventions are often needed to eradicate the infection.

Diagnostic Dilemma of Anaerobic septic arthritis of Sternoclavicular joint in a previously healthy patient: A case report

We came across a 30 year old healthy female patient with severe pain and swelling over the left sternoclavicular joint for three weeks, without any history of trauma. Patient was evaluated elsewhere and empirically started on Antitubercular drugs. Patient was admitted and evaluated as per pain was unpropotionate to her complaints. Computerised Tomography scan revealed eroded medial end of the left clavicle. Magnetic Resonance Imaging scan showed hyper intensity along the sternocleidomastoid and collection in anterior mediastinum. Erythrocyte sedimentation rate and Creactive protein on admission was 120 and 98 respectively. Patient underwent decompressioof the left sternoclavicular joint with resection of the medial end of clavicle and excision of the sinus. Anaerobic culture showed growth of bacteroids. Patient was started on Clindamycin and Metronidazole for six weeks. Patient was symptomatically better. Repeat ESR and CRP was 20 and five at the end of six weeks. We suggest that decompression with appropriate antibiotics should be considered at the earliest in sternoclavicular arthritis.

Sternoclavicular Septic Arthritis Caused by Acupuncture over the Posterior Neck

Acupuncture has been used therapeutically for thousands of years and is considered a relatively safe procedure. Sternoclavicular joint (SCJ) arthritis is a rare joint infection and has never been reported as an adverse event of acupuncture. We report the case of a 50-year-old woman who presented with progressive left neck, shoulder and upper chest pain after acupuncture. A computerized tomography (CT) scan revealed septic arthritis over the left sternoclavicular joint (SCJ) and methicillin-sensitive Staphylococcus aureus bacteraemia was noted. The patient was discharged uneventfully after intravenous antibiotic treatment. SCJ septic arthritis should be considered if unilateral neck and upper chest pain occurs after acupuncture.

Infectious arthritis of sternoclavicular joint: surgical approach to the issue

To study the features of occurrence, diagnosis, clinical course of infectious arthritis of sternoclavicular joint, as well as to develop differentiated therapeutic tactics depending on the clinical form and stage of disease. It was analyzed treatment of 18 patients with infectious arthritis of sternoclavicular joint aged 27 to 88 years who were hospitalized for the period 2008-2014. Acute or chronic forms were determined depending on clinical course and serous arthritis, para-articular phlegmon and osteoarthritis--according to nature of tissue damage. Hypothermia and blunt trauma were often preceded to onset of disease. Diabetes and drug addiction were present as comorbidities. Also disease as the variant of purulent metastasis in case of sepsis was noted. Bone scintigraphy, CT and magnetic resonance imaging are the most informative. Infectious arthritis of sternoclavicular joint often had hematogenous origin, and Staphylococcus aureus was the most common cause. At the stage of serous arthritis antibacterial therapy was effective. Incision and drainage were performed urgently in case of para-articular phlegmon. Sternoclavicular joint resection was performed usually in 2-3 months after subsidence of inflammation.

Sternoclavicular Joint Arthritis: Arthroscopic and Open Resection

Symptomatic sternoclavicular joint arthritis is relatively uncommon. Most patients can be treated successfully by nonoperative measures. However, in a few patients, despite adequate nonoperative treatment, symptoms persist. Open excision arthroplasty and, more recently, an arthroscopic technique have been described for the management of resistant cases. In this article, the anatomy and pathophysiology of sternoclavicular (SC) joint arthritis have been described. The operative techniques and results of open excision arthroplasty are reviewed. The clinical results of most series are good, although the case numbers are low. This may be partly owing to a relative reluctance to undergo surgery because of concerns of potential damage to posterior mediastinal vascular structures. The results for arthroscopic SC excision arthroplasty and the operative technique are described. The clinical results for the arthroscopic technique are comparable to those of the open series but with less perioperative morbidity. Excision arthroplasty for patients with SC arthritis resistant to nonoperative measures is only considered rarely. However, the results for open and arthroscopic excision arthroplasty, although from relatively small series, appear to be consistently good.

Magnetic resonance imaging of sternoclavicular joint arthritis due to SAPHO syndrome

Conditions of the sternoclavicular joints are sometimes misdiagnosed as shoulder diseases because sternoclavicular joints are involved during shoulder joint elevation. When inflammation related to sternoclavicular joint arthritis spreads to the sternocleidomastoid muscles, retroflexion of the neck or rotation to the unaffected side causes pain. Sternoclavicular joint arthritis may be caused by septic arthritis, osteoarthritis, rheumatoid arthritis, SAPHO syndrome, ankylosing spondylitis, psoriasis, gout, or pseudogout. Among those, erosive changes of in sternoclavicular joints have been observed in rheumatoid arthritis, ankylosing spondylitis, psoriasis and SAPHO syndrome. Anti-CCP antibody was negative in this patient, making rheumatoid arthritis unlikely. Ankylosing spondylitis typically develops in young adults and occurs insidiously. Nail lesions and dactylitis were not observed, making psoriatic arthritis unlikely. Among patients with SAPHO syndrome, 6590% experience damage in the bones and joints of the anterior chest. Skin symptoms such as severe acne and palmoplantar pustulosis aid the diagnosis of SAPHO syndrome. However, 3260% of patients develop bone and joint symptoms several years before skin symptoms, and 15% of patients do not develop skin symptoms. Osteolytic changes are often noted at an earlier stage with or without osteosclerotic findings [2]. A computed tomography scan reveals an erosive change in the bone, and MR-STIR imaging shows an abnormally high signal in the bone. MR-STIR imaging can help differentiate active lesions from chronic ones.

Septic arthritis of the sterno-clavicular joint as a cause of dysphagia: a report of two cases and review of literature

Septic arthritis of sterno-clavicular joint is a rare entity which is often associated with predisposing conditions like intravenous drug abuse and diabetes. Its prevalence in healthy subjects with absence of medical co-morbidities has been sporadically reported. Due to the rarity of the condition, diagnosis is often delayed predisposing the patients to serious complications. Clinical suspicion supported by haematological and radiological investigations is needed for early diagnosis. Dysphagia as a complication of sterno-clavicular joint infection has not been reported. In this study, we report a case of sterno-clavicular joint infection causing dysphagia and review the literature with regards to aetiology, predisposing factors and treatment options. The aim of this study is to highlight the importance of early diagnosis in suspected cases of septic arthritis of sterno-clavicular joint and institution of intravenous antibiotics.

Sternoclavicular Joint Arthritis with Acute Kidney Injury

Sternoclavicular Joint Arthritis with Acute Kidney Injury

Septic Arthritis of the Sternoclavicular Joint

Septic arthritis is a medical emergency that requires immediate action to prevent significant morbidity and mortality. The sternoclavicular joint may have a more insidious onset than septic arthritis at other sites. A high index of suspicion and judicious use of laboratory and radiologic evaluation can help solidify this diagnosis. The sternoclavicular joint is likely to become infected in the immunocompromised patient or the patient who uses intravenous drugs, but sternoclavicular joint arthritis in the former is uncommon. This case series describes the course of 2 immunocompetent patients who were treated conservatively for septic arthritis of the sternoclavicular joint.

Sternoclavicular Joint Arthritis as the Initial Presentation of Crohn’s Disease in an Adolescent

Sternoclavicular Joint Arthritis as the Initial Presentation of Crohn’s Disease in an Adolescent

Traumatische Verletzungen des Sternoklavikulargelenks

Traumatic injuries of the sternoclavicular joint occur rarely and are mainly caused by an indirect trauma mechanism with high kinetic energy. Anterior dislocation is much more common than posterior dislocation, which may be associated with life-threatening injuries. The CT scan is the diagnostic tool of choice for accurate assessment of the injury and coexisting pathologies. The primary goal in anterior and posterior dislocations is an early closed reduction. In cases of redislocation after closed reduction of an anterior dislocation we recommend primary joint reconstruction on the basis of an individual therapeutic concept. Posterior dislocations often cannot be reduced by closed means. Then open reconstruction and stabilization are performed. Chronic instabilities should only be addressed surgically in cases of persistent pain and/or functional deficit. Resection of the medial clavicula represents an effective treatment option in post-traumatic sternoclavicular joint arthritis provided that the costoclavicular ligaments are intact or will be reconstructed during surgery. Physeal injuries of the medial clavicle can occur until an approximate age of 25. Closed reduction of dislocated physeal injuries is attempted. After reposition non-operative treatment in general leads to a good functional outcome. Posteriorly dislocated physeal injuries often cannot be reduced by closed means. In these cases good function can be expected after open stabilization.

頸部郭清術後に生じた化膿性胸鎖関節炎の1例

We report a case of pyogenic arthritis of the sternoclavicular joint after neck dissection. An 81-year-oldman was referred to our department because of pain in the right sternoclavicular joint on moving the right upper limb in 2007.In 2003, a malignant tumor of the floor of the mouth with bilateral lymph node metastasis was diagnosed. He received preoperative chemotherapy and underwent resection of the malignant tumor in the floor of the mouth, right total neck dissection, and left functional neck dissection. In addition, he received a total of 63 Gy of radiotherapy. After these treatments, there was no sign of tumor recurrence or distant metastasis. However, in June 2007, the patient had pyrexia, tenderness and swelling of the right sternoclavicular joint, and pain in the joint on moving the right upper limb. CT revealed an abscess in the sternoclavicular joint, and pyogenic arthritis of the sternoclavicular joint was diagnosed by an orthopedist. The right sternoclavicular joint was punctured, but the pus could not be removed. He then received antibiotic therapy. Tenderness and swelling of the right sternoclavicular joint disappeared, and pain in the right sternoclavicular joint also resolved.Three months later, the patient visited us again with similar symptoms of the left sternoclavicular joint. Pyogenic arthritis of the left sternoclavicular joint was diagnosed by an orthopedist, and he was given antibiotic therapy again. Subsequently, the symptoms gradually resolved. The patient is being followed up in our outpatient clinic. No recurrence of pyogenic arthritis of the sternoclavicular joint has occurred until now.

化膿性胸鎖関節炎の１例

胸骨骨髄炎は比較的稀な疾患である．今回我々は，手術的に本疾患を治療し良好な成績を得られたので報告する．症例：40歳，体格の良い男性．既往歴，職歴：既往に特記所見なし，重い荷物を持つ仕事に従事している．現病歴：平成21年4月左胸鎖関節部痛にて発症する．4月胸鎖関節注射を施行するも無効であり，5月病巣掻爬術を施行した．培養検査では，peptococcusが検出された．術後特に大きなトラブルなく現在日常生活上仕事も支障なく行えている．考察と結語：患者が元来健常人である場合，診断，治療が遅れることもあり日常的に本疾患を念頭に置いた診療が必要と考える．

Complications rares d’un syndrome de Lemierre : localisations sternoclaviculaires et pulmonaires excavées

We report a 27-year-old man who presented with a Lemierre's syndrome associated with two uncommon complications: a septic sternoclavicular joint arthritis and a cavitating pneumonia.

Enhanced MR imaging of the shoulder, and sternoclavicular and acromioclavicular joint arthritis in primary hemochromatosis

Shoulder arthritis is a common feature of hemochromatosis. However, a combination of sternoclavicle (SC) and acromioclavicular (AC) joint involvement associated with shoulder is uncommonly seen. We describe the MR imaging findings of the shoulder and SC and AC joint in a patient with primary hemochromatosis. MRI of the left shoulder revealed inflammatory arthritis and 1-cm erosion of the humeral head, enlargement of the anterior glenoid labrum and formation of glenoid labral ovoid mass due to iron deposit. MRI of the AC joint showed inflammation and erosion with joint fluid. Significant contrast enhancement was noted at the SC joint due to inflammation.

Resection arthroplasty of the sternoclavicular joint for the treatment of primary degenerative sternoclavicular arthritis.

We describe the mid-term clinical results of the surgical treatment of primary degenerative arthritis of the sternoclavicular joint in eight women. They had not responded to conservative treatment and underwent a limited resection arthroplasty. For pre- and postoperative clinical evaluation we used the Rockwood score for the sternoclavicular joint. Postoperatively, the Constant score was also determined. The mean follow-up was 31 months (10 to 82). The median Rockwood score increased from 6 to 12.5 points. The median postoperative Constant score was 87 (65 to 91). Four patients had an excellent, three a good, and one a poor result. All patients were pleased with the cosmetic result. Resection arthroplasty is an effective and safe treatment for chronic, symptomatic degenerative arthritis of the sternoclavicular joint with a high degree of patient satisfaction.

Isolated sternoclavicular joint arthritis in heroin addicts and/or HIV positive patients: Three cases

The authors describe three patients in whom septic arthritis of the sternoclavicular joint (SCJ) occurred, drug addiction and human immunodeficiency virus (HIV) infection representing the predisposing conditions. Infectious arthritis is well known in intravenous drug users, but it is rare in HIV positive patients, who are prone to bacterial infections from usual or unusual microorganisms. In one case, staphylococcus aureus methicillin sensitive was responsible for septic arthritis. In another case, SCJ infection was associated with pneumonitis.