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      Tubercular Osteomyelitis Clavicle: A Case Report

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          Abstract

          Introduction:

          Osteomyelitis of the clavicle is a rare entity particularly in adults. Most infective lesions of the clavicle are traumatic and are not difficult to diagnose. Nontraumatic clavicular lesions, on the other hand, are rare and are difficult to diagnosis. It can also occur as a complication of head and neck surgery and subclavian catheter placement.

          Case Report:

          We describe this case in a 61-year-old male who presented with a discharging sinus since 2 years at his left shoulder tip with purulent discharge. Clinicoradiologically, patient was diagnosed as a case of pyogenic osteomyelitis of the lateral end of the clavicle. However, biopsy proved it to be a tubercular osteomyelitis.

          Conclusion:

          Discharging sinus along with secondary infection made diagnosis difficult and delayed appropriate treatment. Thus, as skeletal tuberculosis (TB) can mimic any bony pathology, TB has to be included in the differential diagnosis especially at unusual sites.

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            Tuberculosis of the sternum and clavicle: imaging findings in 15 patients.

            To describe the imaging findings in sterno-clavicular tubercular involvement. Fifteen patients with pathologically proven tuberculosis of the sternum and clavicle were retrospectively evaluated. Routine radiography, computed tomography (CT) and magnetic resonance imaging (MRI) were used in some or all of the patients. Clinical information and imaging features were evaluated in each case. Eight patients had sternoclavicular joint (SCJ) involvement, five had isolated sternal involvement and two had isolated clavicular involvement. Seven patients were evaluated with only CT, six with only MRI and two with both. There were eight male and seven female patients, varying in age between 16 and 78 years. Fever, swelling and pain were common presenting symptoms. Two patients were HIV positive. Radiographs were positive in only eight patients. Destruction and signal intensity (SI) changes of the sternum and clavicle, destruction of the cartilage, soft tissue changes representing granulation tissue/abscess, displacement of the adjacent structures (vessels, trachea, etc.) and inflammatory changes in the adjacent structures in the form of cellulitis and myositis were common imaging features. All imaging methods can provide complementary information regarding sterno-clavicular tubercular involvement that is helpful for determination of the therapy. MRI is useful in determining the extent of the lesion, particularly marrow involvement and soft tissue extent.
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              Post-traumatic osteomyelitis of the clavicle: A case report and review of literature.

              Osteomyelitis of the clavicle is a rare form of infection occurring from hematogenous spread or trauma. This has been reported following head and neck surgery, and subclavian catheter placement. In traumatic cases, the management involves removal of bone fixation, debridement of the bone and coverage with a muscle flap.
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                Author and article information

                Journal
                J Orthop Case Reports
                J Orthop Case Reports
                Journal of Orthopaedic Case Reports
                Indian Orthopaedic Research Group (India )
                2321-3817
                Oct-Dec 2014
                : 4
                : 4
                : 51-53
                Affiliations
                [1 ]Department of Orthopaedics, Himalayan Institute of Medical Sciences, Dehradun, uttrakhand, India
                Author notes
                Address of Correspondence Dr. Rajesh Maheshwari, B-13/1, Swami Rama Himalayan University Campus, Swami Ram Nagar, Jollygrant, Doiwala, Dehradun - 248 140, uttrakhand, India. Email: rajesh1969m@ 123456yahoo.co.in
                Article
                JOCR-4-51
                10.13107/jocr.2250-0685.226
                4719272
                7721a118-acd1-47dd-a3c3-7135ab126e87
                Copyright: © Indian Orthopaedic Research Group

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc-sa/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Case Report

                tuberculosis,clavicle,osteomyelitis
                tuberculosis, clavicle, osteomyelitis

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