Sternoclavicular joint septic arthritis and mediastinitis. A case report and review of the literature

Mikroulis, Dimitrios; Verettas, Dionyssios A.; Xarchas, Konstantinos C.; Lawal, Lukman; Kazakos, Konstantinos; Bougioukas, Georgios J.

doi:10.1007/s00402-006-0273-8

Cited by 18 publications

(14 citation statements)

References 9 publications

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“…Bei Sepsis und evtl. beginnender Mediastinitis wird primär die offene Spülung und ein Débridement sowie Revision und Dränage des vorderen Mediastinums durchgeführt [10,11]. Um eine lokale Keimfreiheit zu erreichen, ist i. d. R. eine prolongierte lokale Behandlung notwendig (z.…”

Section: S19unclassified

Behandlungsstrategie der septischen Arthritiden des Sternoklavikulargelenks

et al. 2014

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Septic arthritis of the sternoclavicular joint (SCJ) is a relatively rare disease. Due to serious complications including mediastinitis and generalised sepsis early diagnosis and rapid onset of treatment are mandatory. The disease often affects immunocompromised patients, diabetics, or patients with other infectious diseases. The therapeutic options range from administration of antibiotics to extended surgery including reconstructive procedures. Apart from rare situations where conservative treatment with antibiotics is sufficient, joint resection followed by plastic surgical procedures are required. We present a retrospective analysis with data from two hospitals. From January 2008 to December 2012 23 patients with radiographically confirmed septic arthritis of various aetiology were included. Fourteen (60.8 %) male, nine (39.2 %) female patients with an average age of 60.3 ± 14.2 years (range: 23-88 years) with septic arthritis of the SCJ were treated. Seven (30.4 %) patients suffered from Diabetes mellitus, nine (39.1 %) had underlying diseases with a compromised immune system. In 14 (60.8 %) out of 23 patients a bacterial focus was detected. Only six (26 %) patients suffered from confined septic arthritis of the SCG, in 17 (73,9 %) patients osteomyelitis of the adjacent sternum, and the clavicle was present. In addition, 15 (65.2 %) patients already suffered from mediastinitis at the time of diagnosis, eight (35 %) patients even from septicaemia. In conclusion, septic arthritis requires an active surgical treatment. Limited incision of the joint and debridement alone is only successful at early stages of the disease. The treatment concept has to include the local joint and bone resection as well as complications like mediastinitis. After successful treatment of the infection, the defect of the chest wall requires secondary reconstructive surgery using a pedicled pectoralis muscle flap.

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Section: S19unclassified

Behandlungsstrategie der septischen Arthritiden des Sternoklavikulargelenks

et al. 2014

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“…Septic arthritis of the sternoclavicular joint (SCJ) is a rare complication [2, 6, 8, 14, 15, 17] and is associated with a number of concomitant diseases. Diabetes mellitus, rheumatoid arthritis, intravenous drug use, intraarticular injection and immunosuppressive disorders are considered predisposing factors [3, 7, 10, 20, 23].…”

Section: Introductionmentioning

confidence: 99%

Surgical management of sternoclavicular septic arthritis

Nusselt

Klinger

Freche

et al. 2010

Arch Orthop Trauma Surg

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IntroductionSeptic arthritis of the sternoclavicular joint (SCJ) is a rare condition and has many diagnostic and therapeutic standards. The purpose of this study was to evaluate our experience with surgical and diagnostic management to provide a surgical pathway to help surgeons treat this disease.MethodWe retrospectively reviewed five patients who were managed surgically between 1999 and 2007. All patients underwent structured diagnostic and treatment protocols. The functional outcome was evaluated using the Constant Score.PatientsThe patients had the following underlying medical conditions: laryngeal cancer, port-explantation linked to a rectum carcinoma, spondylodiscitis, and brain stem infarct with reduced general condition; one patient had no underlying medical problems. Three patients underwent a simple incision, debridement and drainage, and two patients underwent an extended intervention with partial resection of the sternoclavicular joint. The mean duration of follow-up was 29 months (range 24–36 months). All patients had well-healed wounds without signs of reinfection. The Constant Score for the functional outcome at the time of the last follow-up was 76 points (range 67–93 points). All patients recovered completely from SCJ disease.ConclusionOur recommendations for the management of septic arthritis of the sternoclavicular joint include standard treatment steps and assessments. The early stages of infection can be managed by simple incision, debridement and drainage. In advanced stages of infection, a more radical intervention is preferable.

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“…[1][2][3] The development of acute kidney injury (AKI) in association with this entity is very rare. We present herein the management of one such patient.…”

Section: Sternoclavicular Joint Arthritis With Acute Kidney Injurymentioning

confidence: 99%

“…1,3 Immunocompromised states such as chronic renal failure, diabetes, long-term steroid use, malnutrition, and intravenous drug abuse are the predisposing factors. [1][2][3][4] In addition to the broadspectrum antibiotic coverage and drainage of the pus, the presence of bony destruction is an indication of resection surgery (Figure 2). 3,5 Advanced imaging modalities such as computed tomography/magnetic resonance imaging are invaluable in the diagnosis and follow-up.…”

Section: Sternoclavicular Joint Arthritis With Acute Kidney Injurymentioning

confidence: 99%