2015 Volume 58 Issue 1 Pages 27-33
Case 1 involved a 72-year-old man with a 20-year history of diabetes with poor glycemic control who complained of pain in the left sternoclavicular (SC) joint and fever lasting for one week. On admission, he presented with severe pain in the left SC joint, and cervical-CT revealed left SC arthritis with a periarticular abscess. His symptoms improved following the administration of an antimicrobial agent and drainage of the abscess. Case 2 involved a 55-year-old man with a 15-year history of diabetes whose left fifth toe had been amputated due to diabetic gangrene two years earlier. On the present admission, he complained of pain in the right SC joint and fever lasting for one day. The pain in the right SC joint was found to be severe, and cervical-MRI revealed right SC arthritis. His symptoms initially worsened with conservative therapy, although they subsequently improved following drainage of an abscess newly recognized on repeated MRI. Septic SC arthritis is occasionally observed in patients with diabetes; however, the symptoms are often nonspecific, which may result in a delay in the diagnosis potentially leading to serious complications, such as osteomyelitis and mediastinitis. Physicians should thus be aware of the possibility of septic SC arthritis in patients with diabetes who complain of uncertain pain around the SC joint.
