Table 1.
Compilation of all the cases of tuberculosis of sternoclavicular joint.
Cases | Age sex | Site | Clinical features | Duration of symptoms | Radiology | Histology/cytology/ESR/CRP | AFB | Culture | TB-PCR | Treatment | Follow-up | Associated TB | Remark |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | 21/M | B/L | Painful swelling, wt loss, loss of appetite | 6 months | MRI- bilateral lytic area with bone marrow edema with collection Lt SCJ; Chest xray- left pleural effusion; Bone scan- multifocal disease |
USG guided aspiration showed pus ESR-30 |
+ | + | NA | ATT for 8 months | 8 months, symptoms improved and then lost to follow-up | Lung, Spine D5 and D7, Left sided pleural effusion |
Multifocal TB |
2 | 38/F | Lt | Painful swelling, fever | 9 months | MRI- bone marrow edema and cortical erosion with collection; USG- collection in Lt SCJ |
Cytology -Chronic Granulomatous pathology; Histopath- Chronic Granulomatous patholgy; Mantoux- ESR 28 |
+ | – | NA | ATT for 4 months, surgical debridement and ATT continued for 4 months | 8 months, symptom free | None | Misdiagnosed as strain of SCJ and treated conservatively |
3 | 64/F | Rt | Pain | 4 months | MRI- bone marrow edema Rt SCJ | ESR-25 | – | NA | – | ATT for 12 months | 1 year | None | Initially diagnosed as SCJ osteoarthritis |
4 | 29/M | Rt | Painful swelling | 4 months | MRI- erosion of articular margin with synovial thickening and collections with mild subluxation and widening of space | USG guided aspiration; ESR-23 |
– | – | + | ATT for 18 months | 2 years | TB lymphadenitis for 5 months ATT | Conservative treatment from quack |
5 | 56/F | Rt | Painful swelling | 5 months | MRI- marrow edema with periarticular collection | USG guided FNA- granulomatous pathology; ESR-40 |
NA | – | + | ATT for 12 months | 16 months | None | Initially diagnosed as SCJ osteoarthritis |
6 | 30/M | Rt | Painful swelling; history of indirect trauma |
5 months | MRI- marrow edema in medial aspect of clavicle with collection in Lt SCJ | Aspiration-granulomatous pathology; ESR-34 |
– | – | NA | ATT for 12 months | 2 year, then lost to follow-up | None | Traumatic SCJ |
7 | 40/M | Rt | Pain, weight loss, cough, fever | 2 months | Discovered incidentally on chest CT | Cytology -chronic granulomatous pathology; ESR-22 |
NA | + | NA | ATT for 6 months | 6 months | chest TB, pleural effusion, TB lymphadenitis | Multifocal |
8 | 27/F | Rt | Painful swelling | 3 months | MRI- marrow edema with periarticular collection | ESR-31 | + | + | NA | ATT for 12 months | 13 years | None | With pregnancy |
9 | 42/F | B/L | Painful swelling | 6 months | MRI- bone marrow edema and cortical erosion with collection | Cytology -chronic granulomatous pathology; ESR-29 |
NA | NA | + | ATT for 12 months | 2.5 years | None | Recurrent Rheumatoid arthritis |
10 | 11/M | Lt | Painful swelling | 2 months | MRI- marrow edema in medial aspect of clavicle with collection in left SCJ | ESR-17; CRP-9 |
NA | NA | + | ATT for 6 months | 6 months | Pleural effusion | |
11 | 65/M | Rt | Painful swelling | 3 weeks | CT chest - erosion over both SCJ | Cytology -chronic granulomatous pathology; ESR-37 |
– | – | NA | ATT for 4 months | Lost to follow-up after 4 months | Known c/o CKD | |
12 | 30/M | Lt | Painful swelling, discharging sinus | 2 months | MRI- erosion in left SCJ with collection; CT scan- showed destruction involving Lt SCJ |
ESR-70; CRP-49 Montoux - |
– | NA | – | ATT for 5 months | 5 months | Cough and on and off fever with history of weight loss | |
13 | 38/M | Rt | Painful swelling | 1 month | MRI- signal intensity changes over medial aspect of clavicle with erosions and small collections | Aspiration; ESR-17 CRP>10. |
NA | + | + | ATT for 12 months | 19 months | None | |
14 | 19/M | Rt | Painful swelling | 1 month | MRI- collection in SCJ with bone marrow edema | ESR-41; CRP-20 |
NA | – | + | ATT for 12 months | 18 months | None | |
15 | 20/M | Rt | Painful swelling | 2 months | MRI- bilateral SCJ marrow edema With Rt effusion |
ESR-32 | – | – | – | ATT for 9 months | 9 months | None | |
16 | 30/M | Rt | Painful swelling | 6 weeks | MRI- collection in SCJ with bone marrow edema | ESR-29 | – | – | – | ATT for 12 months | 12 months | None |
Abbreviations: M-Male, F-Female, Rt- Right side, Lt- Left side, NA- Not available, ATT- Anti-tubercular therapy, CKD- Chronic kidney disease, SCJ- Sternoclavicular joint, ‘+’ is positive, ‘-’ is negative.