Clinical Features of Septic Arthritis of Sternoclavicular Joint

SOMCHAI AKKASILPA, M.D.*, MANATHIP OSIRI, M.D.*, SITTICHAI UKRITCHON, M.D.*, BOONEK JUNSIRIMONGKOL, M.D.*, UTIS DEESOMCHOK, M.D.*

Affiliation : *Division of Rheumatology, Department of Medicine, Faculty of Medicine, Chulalongkom University, Bangkok 10330, Thailand.

AbstractWe studied 21 patients with septic arthritis of the sternoclavicular joint at Chula longkorn University Hospital between January 1987 and January 1997. There were 15 males (71.4%) and 6 females (28.6%). The mean age was 47.4 years with a range of 16 to 69. More than half of the patients (57 .1%) were aged more than 50 years and most had associated diseases including diabetes mellitus and cirrhosis. Almost all of the younger age group had a history of intravenous drug abuse. All of the patients had fever and sternoclavicular joint pain. Most of the patients (66.7%) had monoarticular arthritis, whereas, the others had oligoarticular arthritis. Staphylococcus aureus was the most commonly or identified organism in the patients. Retrostemal abscess was seen by computerized tomography in 6 patients (28.6% ). All patients received parenteral antibiotics, and 5 patients (23.8%) required surgical drainage of a retrostemal abscess. Eighteen patients recovered but there were 3 (14.3%) deaths. All of these had retrosternal abscesses. The major cause of death was septic shock. Septic arthritis of the sternoclavicular joint is an uncommon disease in Thai clinical practice. Although uncommon, retrosternal abscess is a life threatening complication.

Keywords : Septic Arthritis, Sternoclavicular Joint, Retrosternal Abscess

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