Abstract
We report a case of sterno-costo-clavicular hyperostosis. The patient, a 61-year-old man, complained of pain in the bilateral sterno-clavicular joints and sterno-costal joints. In 1989, pain appeared and was not improved by medical treatment. He visited our department, whereupon it was diagnosed as sterno-costoclavicular hyperostosis. However NSAIDS were not effective for his pain. His symptoms became severe, and in August 1996, he had a checkup again. We recognized bony swelling as inflammation in the right breastbone and collarbone areas. With XP and CT, the bilateral sterno-clavicular joints and sterno-costal joints showed sclerotic change. He had pustulosis palmartis et plantaris and chronic tonsillitis. We initiated steroid therapy, but it was not effective, so we performed tonsillectomy. After the tonsillectomy, inflammation and anterior chest pain disappeared. Furthermore, we administered cefem series antibiotics for 3 months. Most of his symptoms disappeared. Actinomyces lumps in the tonsils ware pathologically examined, and non-specific inflammation and reactivity bone increases were revealed by bone biopsy of the right sterno-claviclar joint. The histological examination indicated the infection lesion in the tonsil and immunoreaction in the sterno-claviclar joint.
