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. 2020 Jul;11(Suppl 4):S557-S567.
doi: 10.1016/j.jcot.2020.04.026. Epub 2020 May 1.

Sternoclavicular joint tuberculosis: A series of conservatively managed sixteen cases

Sanjeev Kumar  1 , Vijay Kumar Jain  1
Affiliations

Sternoclavicular joint tuberculosis: A series of conservatively managed sixteen cases

Sanjeev Kumar et al. J Clin Orthop Trauma. 2020 Jul.

Erratum in

  • Erratum regarding previously published articles.
    [No authors listed] [No authors listed] J Clin Orthop Trauma. 2020 Nov-Dec;11(6):1169-1171. doi: 10.1016/j.jcot.2020.09.032. Epub 2020 Sep 26. J Clin Orthop Trauma. 2020. PMID: 33013141 Free PMC article.
  • Erratum regarding previously published articles.
    [No authors listed] [No authors listed] J Clin Orthop Trauma. 2021 Aug 5;21:101560. doi: 10.1016/j.jcot.2021.101560. eCollection 2021 Oct. J Clin Orthop Trauma. 2021. PMID: 34414073 Free PMC article.

Abstract

Introduction: Sternoclavicular joint tuberculosis is rare with non-specific signs and symptoms thus making correct clinical diagnosis difficult. Delay in diagnosis results in destruction of osteo-ligamentous structures, spread of abscess to deeper planes as well as bursting through skin resulting in joint instability and scar formation.

Material and methods: All the cases of sternoclavicular joint tuberculosis presented to the orthopaedic outdoor between 2004 and 2017 were evaluated clinico-radiologically along with cyto-histopathological and/or microbiological tests to ascertain the diagnosis before initiation of treatment.

Results: There were 11 males and 5 females patients aged 11-65 years (mean, 35 years). Aspiration or curettage of the swelling was performed, and the diagnosis was confirmed in 12 cases by cytology, AFB stain, TB polymerase chain reaction, culture or a combination of these. In 4 patients, anti-tubercular treatment was initiated on clinical suspicion.

Conclusion: Diagnosing sternoclavicular tuberculosis requires multimodal approach. A strong clinical suspicion is required as the presentation is often atypical. Early detection of disease and with conservative treatment resulted in complete remission and minimal long term disability.

Keywords: Conservative; Diagnosis; Sternoclavicular joint; TB; Treatment; Tuberculosis.

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Figures

Fig. 1
Fig. 1
A: Clinical picture showing healed scar. 1B: Chest radiograph with lucency in medial end of clavicle on right side. 1C: Axial section of MRI showing abscess. 1D: Sagittal section of MRI showing collection at medial end of clavicle. 1E: Coronal MRI section showing abscess.
Fig. 2
Fig. 2
A: Clinical picture showing healed scar. 2B: Chest radiograph with destruction of left sternoclavicular joint. 2C&2D: Sagittal and axial section of MRI showing joint destruction.
Fig. 3
Fig. 3
A: Clinical picture showing swelling at left sternoclavicular joint. 3B & 3C: Coronal section of MRI showing collection on left side. 3D & 3E: Axial and Sagittal sections of MRI showing abscess.
Fig. 4
Fig. 4
A: Clinical picture showing swelling at left sternoclavicular joint. 3B: Coronal section of MRI showing collection on left side. 3C: Axial section of MRI. 3D: Sagittal MRI section showing abscess. 4E: NCCT axial section showing affected side with soft tissue component.
Fig. 5
Fig. 5
Diagnostic algorithm showing clinical decision making process for diagnosing sternoclavicular joint tuberculosis.
See this image and copyright information in PMC

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