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sternoclavicular joint

Reyhan Kose, Taskin Senturk, Gokhan Sargin, Songul Cildag, Yasemin Kara
Pustulotic arthro-osteitis (PAO) is a rare chronic inflammatory disease, which has now been classified as a seronegative spondyloarthritis. The sternoclavicular and sternocostal joints, pelvis, vertebra, hip, and long bones are affected. Skin findings of the disease are accepted as a variant of pustular psoriasis, but some authors have suggested that palmoplantar pustulosis (PPP) is a different entity. The synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome should be considered in the differential diagnosis...
February 2018: Eurasian Journal of Medicine
Fabienne Marie-Louise Robertson, Ali Abdullah Mohammed, Simon Peter Frostick
INTRODUCTION: This report describes the first known sternoclavicular joint (SCJ) replacement with a custom-made prosthesis. HISTORY: A 42-year-old male who presented post left medial clavicular excision with significant pain and limited range of motion impeding his daily activities and ability to work. The patient subsequently underwent a left SCJ arthroplasty with a custom-made prosthesis. Postoperatively, the patient suffered an anterior dislocation of the prosthetic joint which was successfully rectified and stabilized with soft tissue reconstruction, creating a pseudo-capsule from adjacent tissues of the joint...
January 2018: Journal of Orthopaedic Surgery
Victoria Rizzo, Yousuf Salmasi, Michael Hunter, Pushpinder Sidhu
Sternal osteomyelitis secondary to mycobacterium tuberculosis (TB) is rare, with <1% of musculoskeletal TB cases reported. The recurrent scenario is unresolving infection and delayed diagnosis. A 75-year-old woman presented with a persistently discharging sternal wound 10 months after coronary artery bypass grafting. Multiple antibiotics, wound debridement and removal of sternal wires was attempted; however, progression to local osteomyelitis and sternoclavicular joint destruction occurred. Tissue biopsies were finally sent for mycobacterial culture testing positive for Mycobacterium tuberculosis High index of suspicion is necessary for diagnosis of sternal tuberculosis, confirmed through timely microbiological investigations...
March 5, 2018: BMJ Case Reports
Yoshihiro Katsuura, Brandon Cincere, Garrick Cason, James Osborn
Here, we present a rare case of metastatic methicillin sensitive Staphylococcus aureus (MSSA) infection arising from an unknown focus and spreading throughout the lumbar spine with associated pyomyositis of the paraspinal musculature, and septic arthritis of the knee, ankle and sternoclavicular joint. This case highlights the potential for missed aspects and delay in diagnosis in the care of metastatic S. aureus and the need for multispecialty intervention. Treatment of S. aureus infections requires a high index of suspicion and careful examination of multiple organ systems to identify the full extent of the disease...
March 5, 2018: BMJ Case Reports
Carmen Martinez-Aparicio, Satu K Jääskeläinen, José M Muyor, Björn Falck
INTRODUCTION: We describe a new nerve conduction study technique with reference values for the three branches of the supraclavicular nerve (SCN) in young healthy subjects and application of it in two patients. METHODS: The recording electrode was placed on the posterior border of the sternocleidomastoid muscle, 6-7 cm from the sternoclavicular joint. SCN branches were stimulated below the clavicle, 2.5, 7 and 10.5 cm lateral to the sternoclavicular joint. RESULTS: Twenty healthy volunteers (10 men), 19-38 years, mean 25...
February 21, 2018: Muscle & Nerve
Baris Gun, Robert Dean, Beatrice Go, Catherine Richardson, Brian R Waterman
INTRODUCTION: Sternoclavicular joint (SCJ) dislocations, although uncommon, are observed in patients with ligamentous laxity as well as those who experience traumatic injuries. The incidence and epidemiology of this costly and debilitating injury to our relatively young and active military population have not previously been reported. The purpose of this study is to consider and quantify the non-modifiable risk factors associated with this injury. METHODS: Using Defense Medical Epidemiological Database, first-time occurrences, from 2006 to 2015 for the ICD-9-CM code 839...
February 6, 2018: Military Medicine
Dean Wang, Christopher L Camp, Brian C Werner, Joshua S Dines, David W Altchek
Dislocation of the sternoclavicular joint is a rare injury and typically requires high-energy forces applied through the joint. Initial treatment is dependent on the direction of dislocation, with acute reduction indicated for posterior dislocations presenting with signs of tracheal, esophageal, or neurovascular compression. Although most patients do well with conservative treatment after the initial trauma, some can have persistent pain and scapular dyskinesia due to instability or locked dislocation of the sternoclavicular joint...
October 2017: Arthroscopy Techniques
Graham Tytherleigh-Strong, Lee Van Rensburg
Osteoarthritis changes at the sternoclavicular joint (SCJ) have been shown to be present on computed tomography in more than 90% of people over the age of 60 years. Although usually asymptomatic, when symptoms do occur, they can be very debilitating. Most patients respond favorably to conservative treatment, but there is a small cohort of patients who continue to be symptomatic despite adequate conservative treatment. Surgical management with an open SCJ excision has been shown to give satisfactory results...
October 2017: Arthroscopy Techniques
Andrzej Smereczyński, Katarzyna Kołaczyk, Elżbieta Bernatowicz
The chest wall is a vast and complex structure, hence the wide range of pathological conditions that may affect it. The aim of this publication is to discuss the usefulness of ultrasound for the diagnosis of benign lesions involving the thoracic wall. The most commonly encountered conditions include sternal and costal injuries and thoracic lymphadenopathy. Ultrasound is very efficient in identifying the etiology of pain experienced in the anterior chest wall following CPR interventions. Both available literature and the authors' own experience prompt us to propose ultrasound evaluation as the first step in the diagnostic workup of chest trauma, as it permits far superior visualization of the examined structures compared with conventional radiography...
December 2017: Journal of Ultrasonography
George Sanchez, Nicholas I Kennedy, Márcio B Ferrari, Angela Chang, Matthew T Provencher
A dislocation of the sternoclavicular joint is a particularly threatening injury given the close proximity of neighboring vital structures. Moreover, a traumatic injury resulting in a comminuted fracture of the medial clavicle in addition to joint instability results in even greater complexity. In the setting of sternoclavicular joint instability, definitive treatment that will lead to complete resolution of symptoms is necessary. Various treatment methods, both conservative and operative, with positive treatment outcomes have been described...
August 2017: Arthroscopy Techniques
Rongguang Ao, Yalong Zhu, Jianhua Zhou, Zhen Jian, Jifei Shi, Cheng Li, Wankun Hu, Baoqing Yu
BACKGROUND: Traumatic sternoclavicular joint dislocations are rare; closed reduction is the primary treatment. The failure of closed reduction or a prominent insult to the skin may require surgery to ensure the best possible outcome. METHODS: The records of 5 patients operated at our institution for sternoclavicular joint dislocation were reviewed. All patients were treated with open reduction and single 3.5-mm locking plate was used for fixation. Outcomes were evaluated with the Constant Shoulder Score (CSS) and Disability of the Arm, Shoulder, and Hand (DASH) questionnaire...
January 9, 2018: BMC Musculoskeletal Disorders
Wanpeng Li, Hongming Xu, Liming Zhao, Xiaoyan Li
BACKGROUND: Branchial anomalies (BAs) account for 20% of all congenital masses in children. We sought to review the incidence of involvement of individual anomalies, diagnostic methods, surgical treatment, and complications of BAs in children. In addition, we also classified our study and analyzed a congenital lower neck cutaneous fistula near the sternoclavicular joint that was thought to be the skin-side remnant of the fourth BAs. METHODS: We conducted a retrospective analysis of 105 children who were referred to our hospital from June 2009 to December 2016 for the treatment of BAs...
January 2018: International Journal of Pediatric Otorhinolaryngology
Scott A McAninch, Clinton Smithson, Andrew L Juergens, Jason N Collins, Amrita Nanda
BACKGROUND: Sternoclavicular joint infection (SJI), to include septic arthritis (SA), is a rare cause of chest pain and is often found in patients with significant risk factors and sources for SA. Most acute care laboratory results lack significant sensitivity to rule out SA. Radiographic findings in common acute care imaging often does not reveal findings of SA and osteomyelitis in the acute phase of the infection. CASE REPORT: We present a patient without significant risk factors for SA, who initially presented with 3 days of pain to the left chest, left neck and shoulder...
December 14, 2017: Journal of Emergency Medicine
Rebecca Gologorsky, Benjamin Hornik, Jeffrey Velotta
Tietze syndrome is a rare and benign cause of chest pain that may be confused with life-threatening conditions. Characteristic findings are painful, localized inflammation of the costosternal, sternoclavicular, or costochondral joints typically of the second and third ribs. We present a patient with severe, medically refractory symptoms consistent with Tietze syndrome. Although surgical management is not the typical treatment course, symptomatic control was eventually achieved with complete resection of the involved cartilage and adjacent rib...
December 2017: Annals of Thoracic Surgery
Georgios Mamarelis, Mohammad Zain Sohail, Athanasios Mamarelis, Hassan Fawi, Jehangir Mahaluxmivala
Introduction: Septic arthritis of the sternoclavicular (SC) joint is a rare condition. Typically, it presents in patients with risk of infection and is usually unilateral. In this report, we describe a case of spontaneous bilateral sternoclavicular joint infection of an otherwise healthy adult. Case Presentation: A 67-year-old man presented in our hospital complaining of 2-week history of neck and chest pain which was radiating to his shoulders bilaterally. Clinical examination revealed erythema and swelling of the sternoclavicular area...
2017: Case Reports in Orthopedics
Renaldi Prasetia, Hermawan Nagar Rasyid
INTRODUCTION: Bipolar dislocation of the clavicle, also called bifocal or pan-articular dislocation or floating clavicle, is an uncommon traumatic injury. The injury of this case is also concomitant with distal third clavicle and coracoid fracture. This article aimed to report the experience of performing osteosynthesis and early soft tissue reconstruction on these injuries. CASE REPORT: We reported a case of bipolar clavicle fracture-dislocation in concomitant with coracoid fracture in a man, aged 32 years old, successfully treated 24days after accident by fixation of both fractures and early simultaneous reconstruction of sternoclavicular- acromioclavicular-coracoclavicular joints...
October 27, 2017: International Journal of Surgery Case Reports
Andrzej Smereczyński, Katarzyna Kołaczyk, Elżbieta Bernatowicz
Chest wall ultrasound has been awarded little interest in the literature, with chest wall anatomy described only in limited extent. The objective of this study has been to discuss the methodology of chest wall ultrasound and the sonographic anatomy of the region to facilitate professional evaluation of this complex structure. The primarily used transducer is a 7-12 MHz linear one. A 3-5 MHz convex (curvilinear) transducer may also be helpful, especially in obese and very muscular patients. Doppler and panoramic imaging options are essential...
September 2017: Journal of Ultrasonography
Thomas Taylor, Marcus Coe, Ana Mata-Fink, Richard Zuckerman
Propionibacterium species are associated with normal skin flora and cultures may be dismissed as contaminants. They are increasingly recognized as a cause of septic arthritis following shoulder arthroplasty and arthrotomy. We identified three cases of Propionibacterium septic arthritis in native joints mimicking atypical osteoarthritis and review the literature, clinical course, and treatment of 18 cases. Two cases of Propionibacterium acne in native knee joints and one in a sternoclavicular joint are described...
October 2, 2017: Infectious Disease Reports
Kevin G Buell, Saira Ajmal, Jennifer A Whitaker
Empyema necessitans is a complication of a pleural space infection that dissects through the pleura into the soft tissues of the chest and skin. Due to the widespread availability of antibiotics, empyema necessitans is rare in modern medicine and is most commonly caused by Mycobacterium tuberculosis. A 38-year-old immunocompetent male presented with left shoulder pain and his chest radiograph revealed a mass in the upper left lung and/or pleural space. He underwent multiple debridements of the chest wall due to a left chest wall abscess and empyema necessitans...
August 22, 2017: Curēus
S Adamo, J Nilsson, A Krebs, U Steiner, A Cozzio, L E French, A G A Kolios
Synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome is a rare disease with inflammatory osteoarticular and skin involvement. The pathogenesis of SAPHO syndrome remains unclear, but evidence suggests it may be an autoinflammatory disease triggered upon exposure to infectious agents in genetically predisposed individuals. Induction of the IL-23/Th17 axis as well as neutrophil activation seem to play a key role, and therapies targeting these immunological pathways, including TNF-inhibitors, ustekinumab, secukinumab and the IL-1 inhibitor anakinra are potential treatment options that need further investigation...
October 16, 2017: British Journal of Dermatology
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