Presentation
Recalcitrant midline and right chest wall pain.
Patient Data
Erosions of the sternal synchondrosis, diffuse sclerosis of the neighboring bone.
Bone edema around the sternal synchondrosis, which shows irregular contours and enhances after contrast. There is also massive edema and contrast enhancement around the sternal ends of the 1st - 4th right ribs, indicating periostitis/perichondritis.
Case Discussion
Whole body bone scintigraphy must be performed in this case to detect possible other manifestations of OM, for the chest wall is preferentially affected in chronic recurrent multifocal osteomyelitis (CRMO) or the SAPHO syndrome.