Abstract
The sternoclavicular joint (SCJ) is a rare site for infection. We report a case of septic arthritis of the SCJ.
A 66-year-old diabetic man complained of pain in the anterior left neck. Redness and swelling were evident in the area of the left SCJ. The white cell count was 18,290/µl and the CRP level was 33.24mg/dl. Magnetic resonance imaging (MRI) showed inflammatory swelling around the left SCJ. An aspirate obtained by CT-guided needle puncture grew Staphylococcus aureus. Consevative therapy ineffective, and MRI about two weeks later showed osteomyelitis of the left clavicle and destruction of the left SCJ. Curettage and irrigation were performed, but the CRP level remained high. Therefore, we performed curettage under continuous irrigation, and filled the bone defect with cement beads. Four weeks later, we removed of the cement beads and covered the bone defect with the ipsilateral pectoralis major muscle.
Early diagnosis and therapy for septic arthritis of the SCJ is important. MRI is useful for early diagnosis and a correct choice of treatment. Furthermore, debridement with cement beads and coverage of the bone defect with the ipsilateral pectoralis major muscle aids complete recovery.
