The value of tomography in diagnosing infection of the sternoclavicular joint

The diagnosis of infectious sternoclavicular arthritis is often missed in the early stages. Five patients with this disease were diagnosed only after the development of erosive changes of the articular surface. Even then, the erosive changes and the periarticular soft-tissue masses could not be delineated without the aid of conventional and computed tomography. Tomography of the joint appears to be essential in making an early diagnosis of infection of the sternoclavicular joint. In reviewing the literature, infection of the sternoclavicular joint appears to be relatively uncommon and occurs predominantly in drug addicts with gram-negative bacillary infections. This statement may be misleading. It is our experience that infection of the sternoclavicular joint can occur in otherwise healthy individuals, gram-positive cocci being the offending agent.