Septic Arthritis Of Sternoclavicular Joint Research Articles

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.

E15. Sternoclavicular Joint Septic Arthritis in the Rheumatology Clinic: High Clinical Suspicion Needed

E15. Sternoclavicular Joint Septic Arthritis in the Rheumatology Clinic: High Clinical Suspicion Needed

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.

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.

A case of strenoclavicular septic arthritis with mediastinitis managed conservatively and literature review

We present the case of a 66 year old diabetic female with left sided Sternoclavicular Joint (SCJ) Septic Arthritis (SA) who presented with atypical chest pain and reduced left shoulder movement. The case was initially misdiagnosed in the emergency department as a soft tissue injury of the shoulder. She re-presented a week later with fevers and raised inflammatory markers. The treating medical team had a high index of suspicion for a SCJ infection and investigated the patient in a timely manner. She was found to have left SCJ SA complicated by mediastinitis and abscess formation. Treatment consisted of intravenous antibiotics for 4 weeks, without any surgical intervention, followed by 8 weeks of oral antibiotics. The patient made a complete functional recovery. We present this case in detail and perform a review of the published literature regarding this rare entity.

Sternoclavicular joint septic arthritis following paraspinal muscle abscess and septic lumbar spondylodiscitis with epidural abscess in a patient with diabetes: a case report

BackgroundSeptic arthritis of the sternoclavicular joint (SCJ) is extremely rare, and usually appears to result from hematogenous spread. Predisposing factors include immunocompromising diseases such as diabetes.Case presentationA 61-year-old man with poorly controlled diabetes mellitus presented to our emergency department with low back pain, high fever, and a painful mass over his left SCJ. He had received two epidural blocks over the past 2 weeks for severe back and leg pain secondary to lumbar disc herniation. He did not complain of weakness or sensory changes of his lower limbs, and his bladder and bowel function were normal. He had no history of shoulder injection, subclavian vein catheterization, intravenous drug abuse, or focal infection including tooth decay. CT showed an abscess of the left SCJ, with extension into the mediastinum and sternocleidomastoid muscle, and left paraspinal muscle swelling at the level of L2. MRI showed spondylodiscitis of L3-L4 with a contiguous extradural abscess. Staphylococcus aureus was isolated from cultures of aspirated pus from his SCJ, and from his urine and blood. The SCJ abscess was incised and drained, and appropriate intravenous antibiotic therapy was administered. Two weeks after admission, the purulent discharge from the left SCJ had completely stopped, and the wound showed improvement. He was transferred to another ward for treatment of the ongoing back pain.ConclusionDiabetic patients with S. aureus bacteremia may be at risk of severe musculoskeletal infections via hematogenous spread.

Sternoclavicular joint septic arthritis and osteomyelitis caused by Aggregatibacter aphrophilus

A 62-year-old lady was referred to the Infectious Diseases outpatients clinics with a 3-week history of right shoulder pain and a 1-week history of progressive swelling and erythema of the soft tissue overlying the right sternoclavicular joint (SCJ). No systemic symptoms were reported. No triggering event could be recalled and there was no recent travel, no animal exposure and no known contact with tuberculosis. On examination, temperature was normal and the patient appeared systemically well. There was an indurated, tender, erythematous, warm swelling over her right SCJ with associated decreased range of movement of the right shoulder. Cardiac examination revealed a soft systolic murmur. No other peripheral stigmata of endocarditis were identified. The patient was admitted for investigation and work up of a suspected SCJ septic arthritis arising either as a consequence of an undocumented bacteraemia or due to a contiguous extension from overlying skin and soft tissue infection. Initial laboratory investigations revealed a normal white cell count and differential. Inflammatory markers were elevated with an ESR of 94 mm/h (<36) and a CRP of 84 mg/l (<5). Serial blood cultures were obtained prior to therapy commencement. A targeted ultrasound (US) of the SCJ was performed urgently. This identified a small pocket of fluid adjacent to the right SCJ, intimately associated with the joint space. This fluid was aspirated under US guidance. Treatment comprising high-dose intravenous (IV) flucloxacillin and benzylpenicillin was subsequently commenced. Imaging with computed tomography and magnetic resonance (MR) revealed marked soft tissue oedema surrounding the SCJ associated with oedema and inflammatory changes in the adjacent bone and parietal pleura (Figure 1a and b). A transthoracic echocardiogram did not identify any features suggestive of endocarditis. This finding was later confirmed with a trans-oesophageal echocardiogram. Figure 1. ( a ) Computed tomography image. Marked …

Imaging Appearances of the Sternum and Sternoclavicular Joints

The sternum and sternoclavicular joints--critical structures of the anterior chest wall--may be affected by various anatomic anomalies and pathologic processes, some of which require treatment. Pectus excavatum and pectus carinatum are common congenital anomalies that are usually benign but may warrant surgical treatment if they cause compression of vital internal structures. By contrast, developmental variants such as the sternal foramen are asymptomatic and do not require further evaluation or treatment. Arthritides of the sternoclavicular joint (osteoarthritis, septic arthritis, and seronegative arthropathies) are common and must be differentiated before an appropriate management method can be selected. The recognition of complications of sternotomy (eg, sternal dehiscence, secondary osteomyelitis) is critical to avoid life-threatening sequelae such as acute mediastinitis. Likewise, the detection of sternal fractures and sternoclavicular dislocations is important, especially where they impinge on vital structures. In addition, sternal malignancies (most commonly, metastases and chondrosarcoma) must be distinguished from benign neoplasms. To achieve accurate and timely diagnoses that facilitate appropriate treatment, radiologists must be familiar with the appearances of these normal anatomic variants and diseases of the sternum.

Bilateral sternoclavicular joint septic arthritis secondary to indwelling central venous catheter: a case report

IntroductionSeptic arthritis of the sternoclavicular joint is rare, comprising approximately 0.5% to 1% of all joint infections. Predisposing causes include immunocompromising diseases such as diabetes, HIV infection, renal failure and intravenous drug abuse.Case presentationWe report a rare case of bilateral sternoclavicular joint septic arthritis in an elderly patient secondary to an indwelling right subclavian vein catheter. The insidious nature of the presentation is highlighted. We also review the literature regarding the epidemiology, investigation and methods of treatment of the condition.ConclusionSCJ infections are rare, and require a high degree of clinical suspicion. Vague symptoms of neck and shoulder pain may cloud the initial diagnosis, as was the case in our patient. Surgical intervention is often required; however, our patient avoided major intervention and settled with parenteral antibiotics and washout of the joint.

中心静脈カテーテルポート留置後に生じた化膿性胸鎖関節炎の1例

皮下埋込型薬液注入システム（静注用）（以下CVポートと略す）留置後に化膿性胸鎖関節炎を発症した症例を経験したので報告する．症例は51歳，女性．進行大腸癌に対し右鎖骨下よりCVポートを留置し，mFOLFOX6療法を施行した．ポート周囲に発赤，疼痛を認めたためCVポートを抜去した．抜去後，右肩・頸部痛，右胸鎖関節部の腫脹，疼痛を認め，画像所見から化膿性胸鎖関節炎と診断した．抗菌薬投与を開始し，穿刺部に皮下膿瘍の形成を認めたため切開排膿処置を行い軽快した．化膿性胸鎖関節炎は比較的稀な疾患で，化学療法施行症例では免疫低下状態から本症を発症しやすく，重症化すると敗血症に至ることがある．CVポート関連感染症を疑った際には，早期の対応が重要であると思われた．

Sternoclavicular joint septic arthritis and mediastinitis. A case report and review of the literature

Septic arthritis of the sternoclavicular joint is rare. Its causes have been reported to include immuno-compromizing diseases, intravenous drug abuse, fractures of the clavicle or catheterization of the subclavian vein. We report a case of septic arthritis of the SCJ in a diabetic patient following periarticular injection of steroids in the ipsilateral shoulder, as this route of infection has not been documented, to our knowledge, in the literature to date. We review the literature regarding epidemiology and methods of surgical treatment that have been proposed, and present our own surgical experience. Bacterial infection should always be suspected in cases of SCJ arthritis. If surgery is required, it is important to remember that bony procedures leave vascular structures exposed, making their cover by myoplasty mandatory.

Pseudomonas aeruginosa Septic Arthritis Treatment Failure With Ceftazidime and Amikacin in a Chronic Hemodialysis Patient Successfully Treated With Meropenem

Pseudomonas aeruginosa Septic Arthritis Treatment Failure With Ceftazidime and Amikacin in a Chronic Hemodialysis Patient Successfully Treated With Meropenem

Sternoclavicular Joint Septic Arthritis Manifesting as a Neck Abscess: A Case Report

Septic arthritis of the sternoclavicular joint is an uncommon condition, and the diagnosis can be missed until a complication occurs. The sternoclavicular joint is more often involved in ankylosing spondylitis, degenerative arthritic conditions (i.e., rheumatoid arthritis and osteoarthritis), and primary and secondary metastatic conditions. The patient described in this case report came to the otolaryngology department on two occasions for treatment of a unilateral cutaneous neck abscess. The correct diagnosis was not made until the second visit. The author reviews the clinical course, diagnosis, and treatment of this uncommon disease.

Sternoclavicular Joint Septic Arthritis.

Sternoclavicular Joint Septic Arthritis.

Sternoclavicular joint septic arthritis with small-colony variant Staphylococcus aureus

Small-colony variants of Staphylococcus aureus may cause invasive disease in adults that is prolonged and refractory to standard therapies. We present a case of sternoclavicular arthritis with small-colony variant S. aureus that occurred in an 11-year-old child and discuss the importance of identification of these variants in the clinical microbiology laboratory.