Sternoclavicular Pathology

 

Condensing Osteitis

 

Epidemiology

- seen in women over 40

 

Xray

- sclerotic and overgrown

 

Condensing Osteitis Xray

 

CT

 

Condensing Osteitis CT 2Condensing Osteitis CT

 

NHx

 

Sng Ann Acad Med Sing 2004

- follow up of 9 patients mean 34 months

- pain reduced over time

 

Management

 

Refractory

Will resolve with time

 

Options

- HCLA injection

- excision

 

Friedrich's Disease

 

Very rare condition seen in young adults

- AVN of sternal end of clavicle / occasionally lateral end

- pain and swelling

- ESR may be raised

- irregular sclerotic appearance on xray

- rarely requires excision

 

Sternoclavicular Hyperostosis

 

Bilateral condition

- ossification of sternoclavicular ligaments

- may lead to solid ossification with restriction of shoulder motion

- associated with pustules and elevated Alk Phos

 

Osteoarthritis

 

Sternoclavicular OA

 

SCJ OA MRI 1SCJ OA MRI 2

 

Options

 

1.  Intra-articular cortisone

2.  Fusion