The sternoclavicular joint (SCJ) is an unusual site for infection. We report a case of pyogenic arthritis of the SCJ.
A 79-year-old man who was diabetic complained of pain and swelling in the left SCJ. Magnetic resonance imaging (MRI) showed arthritis of the SCJ and abcesses around the SCJ. A needle aspiration of the abcess grew Staphylococcus aureus. He underwent drainage and antibiotic therapy at another hospital, but the inflammation of the SCJ did not improve. MRI about a month later after the beginning of the treatment showed osteomyelitis of the left clavicle, so he was referred to our hospital. He was not pyrexial, white cell count was normal, CRP was 5.65 mg/dl, and ESR was 58 mm/l st h. Plain SCJ X-rays were unremarkable, but MRI and bone scintigraphy showed arthritis and osteomyelitis. He underwent a debridement with an ipsilateral pectoralis major muscle covering the bony defect. After the debridment, there is no recurrence. When there is evidence of infection beyond the SCJ such as myelitis, aggressive surgical therapy is necessary.
