[Tuberculosis of the sternoclavicular joint].
Tuberculosis is seen in every part of the body, but sternoclavicular joint tuberculosis is rare. We report a case of tuberculosis of the sternoclavicular joint in 70-year-old woman having complained of the right sternoclavicular joint swelling. She had a previous history of pulmonary tuberculosis, and visited her doctor for right sternoclavicular joint swelling on February 2006. A chest CT scan showed a low density area with destructive osseous changes in the right sternoclavicular joint. Definite diagnosis could not be done by twice needle biopsy, but we diagnosed her as tuberculosis of the sternoclavicular joint based on the clinical course and the findings of the examination. As her condition did not improve after 3 months treatment with anti-tuberculous drugs, we conducted therapeutic surgical procedure. Definite diagnosis of sternoclavicular joint tuberculosis was made on the basis of the presence of mycobacteria in the histological specimen and PCR-TB positive result. We kept the wound opened and continued administration of anti-tuberculous drugs, and her condition does not deteriorate. Tuberculosis should be considered in case of a patient with arthritis and previous history of tuberculosis, even if it is seen in rare location. Diagnostic and therapeutic surgical procedure should be taken into consideration, if there is no improvement of the condition after a diagnosis of bone and joint tuberculosis, and the administration of chemotherapy for tuberculosis.
Kawasaki
Takeshi
T
Department of Thoracic Disease, National Hospital Organization Chiba-East National Hospital, 673 Nitona-cho, Chuo-ku, Chiba-shi, Chiba 260-8712, Japan. t-kawa@cehpnet.com
Sasaki
Yuka
Y
Shinozaki
Aya
A
Bekku
Rei
R
Hashimoto
Tomohiro
T
Yagi
Takenori
T
Yamagishi
Fumio
F
D000995:Antitubercular Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003646:Debridement; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D013247:Sternoclavicular Joint; D016896:Treatment Outcome; D014394:Tuberculosis, Osteoarticular / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D014397:Tuberculosis, Pulmonary / Q000150:complications
D000995:Antitubercular Agents