Sternoclavicular septic arthritis in a previously healthy patient: a case report and review of the literature

Ibrahimi, Abdelhalim El; Daoudi, A.; Boujraf, Saïd; Elmrini, Abdelmajid; Boutayeb, F.

doi:10.1016/j.ijid.2008.07.024

Cited by 32 publications

(36 citation statements)

References 10 publications

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“…An infection must be considered in any patient complaining of unilateral SCJ pain until proven otherwise. MSSA is the most common pathogen [4] . An empiric antibiotic against methicillinresistant Staphylococcus aureus (MRSA) is indicated if the patient has risk factors such as intravenous drug use, haemodialysis, central venous access, recent hospitalization, or lives in an MRSA high-prevalence area.…”

Section: Discussionmentioning

confidence: 99%

Sternoclavicular Septic Arthritis Caused by Acupuncture over the Posterior Neck

Liu¹,

Wang

Hung

2015

European Journal of Case Reports in Internal Medicine

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Acupuncture has been used therapeutically for thousands of years and is considered a relatively safe procedure. Sternoclavicular joint (SCJ) arthritis is a rare joint infection and has never been reported as an adverse event of acupuncture. We report the case of a 50-year-old woman who presented with progressive left neck, shoulder and upper chest pain after acupuncture. A computerized tomography (CT) scan revealed septic arthritis over the left sternoclavicular joint (SCJ) and methicillin-sensitive Staphylococcus aureus bacteraemia was noted. The patient was discharged uneventfully after intravenous antibiotic treatment. SCJ septic arthritis should be considered if unilateral neck and upper chest pain occurs after acupuncture. LEARNING POINTS• Sternoclavicular joint (SCJ) septic arthritis is rare but must be considered in any patient complaining of unilateral SCJ pain.• Acupuncture over the neck area may result in SCJ septic arthritis.• Infection control measures could minimize the number of adverse effects of acupuncture.

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Section: Discussionmentioning

confidence: 99%

Sternoclavicular Septic Arthritis Caused by Acupuncture over the Posterior Neck

Liu¹,

Wang

Hung

2015

European Journal of Case Reports in Internal Medicine

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“…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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“…SCJ infection is generally unilateral, affecting the right side in approximately 60% of cases. This difference in occurrence between sides is less apparent in intravenous drug abusers [4,17]. According to El Ibrahimi, bacteremia was the most commonly assumed mechanism of infection [17].…”

Section: Discussionmentioning

confidence: 99%

“…This difference in occurrence between sides is less apparent in intravenous drug abusers [4,17]. According to El Ibrahimi, bacteremia was the most commonly assumed mechanism of infection [17]. As in most joints, septic arthritis of the SCJ is most commonly caused by S. aureus , followed by pseudomonas species [18,19].…”

Section: Discussionmentioning

confidence: 99%

Sternoclavicular joint septic arthritis following paraspinal muscle abscess and septic lumbar spondylodiscitis with epidural abscess in a patient with diabetes: a case report

et al. 2012

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BackgroundSeptic arthritis of the sternoclavicular joint (SCJ) is extremely rare, and usually appears to result from hematogenous spread. Predisposing factors include immunocompromising diseases such as diabetes.Case presentationA 61-year-old man with poorly controlled diabetes mellitus presented to our emergency department with low back pain, high fever, and a painful mass over his left SCJ. He had received two epidural blocks over the past 2 weeks for severe back and leg pain secondary to lumbar disc herniation. He did not complain of weakness or sensory changes of his lower limbs, and his bladder and bowel function were normal. He had no history of shoulder injection, subclavian vein catheterization, intravenous drug abuse, or focal infection including tooth decay. CT showed an abscess of the left SCJ, with extension into the mediastinum and sternocleidomastoid muscle, and left paraspinal muscle swelling at the level of L2. MRI showed spondylodiscitis of L3-L4 with a contiguous extradural abscess. Staphylococcus aureus was isolated from cultures of aspirated pus from his SCJ, and from his urine and blood. The SCJ abscess was incised and drained, and appropriate intravenous antibiotic therapy was administered. Two weeks after admission, the purulent discharge from the left SCJ had completely stopped, and the wound showed improvement. He was transferred to another ward for treatment of the ongoing back pain.ConclusionDiabetic patients with S. aureus bacteremia may be at risk of severe musculoskeletal infections via hematogenous spread.

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Sternoclavicular septic arthritis in a previously healthy patient: a case report and review of the literature

Cited by 32 publications

References 10 publications

Sternoclavicular Septic Arthritis Caused by Acupuncture over the Posterior Neck

Sternoclavicular Septic Arthritis Caused by Acupuncture over the Posterior Neck

Surgical management of sternoclavicular septic arthritis

Sternoclavicular joint septic arthritis following paraspinal muscle abscess and septic lumbar spondylodiscitis with epidural abscess in a patient with diabetes: a case report

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