Sternoclavicular joint septic arthritis

Case contributed by Dr Bruno Di Muzio

Presentation

Painful lump in the region of the left sternoclavicular joint.

Patient Data

Age: 55 years
MRI

MRI Left clavicle

There is a cortical destruction of the sternoclavicular joint margins associated with adjacent bone marrow oedema and enhancement, as well as an irregular fluid collection within the joint space. Extensive inflammatory changes noted within the adjacent soft tissues, including muscular oedema, in particular of the pectoralis major and sternocleidomastoid muscles. Small soft tissue collection anterior to the clavicle 14 mm lateral to the joint. No soft tissue collections elsewhere. Multiple enlarged likely reactive left neck lymph nodes. The imaged neck vessels have preserved flow voids.

Ultrasound

US Neck (targeted study for FNA)

Thickening and hyperaemia of the left sternocleidomastoid, in particular of the clavicular head. The patient is most tender over this region. Surrounding lymphadenopathy. Small effusion of the left sternoclavicular joint has bee sampled. 

Case Discussion

Imaging features are consistent with sternoclavicular joint septic arthritis.

 

MICROSCOPY

GRAM STAIN

  • Leucocytes +
  • Gram positive cocci +
  • Calcium pyrophosphate crystals detected - indicative of pseudogout.

CULTURE Staphylococcus aureus +++

 

PlayAdd to Share

Case information

rID: 54385
Case created: 7th Jul 2017
Last edited: 10th Jul 2017
Tag: rmh
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.