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胸锁关节化脓性关节炎与纵隔炎。病例报告及文献综述。

Sternoclavicular joint septic arthritis and mediastinitis. A case report and review of the literature.

作者信息

Mikroulis Dimitrios A, Verettas Dionyssios A, Xarchas Konstantinos C, Lawal Lukman A, Kazakos Konstantinos J, Bougioukas Georgios J

机构信息

Department of Cardiac and Thoracic Surgery, Democritus University of Thrace, Alexandroupolis, Greece.

出版信息

Arch Orthop Trauma Surg. 2008 Feb;128(2):185-7. doi: 10.1007/s00402-006-0273-8. Epub 2006 Dec 23.

Abstract

Septic arthritis of the sternoclavicular joint is rare. Its causes have been reported to include immuno-compromizing diseases, intravenous drug abuse, fractures of the clavicle or catheterization of the subclavian vein. We report a case of septic arthritis of the SCJ in a diabetic patient following periarticular injection of steroids in the ipsilateral shoulder, as this route of infection has not been documented, to our knowledge, in the literature to date. We review the literature regarding epidemiology and methods of surgical treatment that have been proposed, and present our own surgical experience. Bacterial infection should always be suspected in cases of SCJ arthritis. If surgery is required, it is important to remember that bony procedures leave vascular structures exposed, making their cover by myoplasty mandatory.

摘要

胸锁关节化脓性关节炎较为罕见。据报道,其病因包括免疫功能低下疾病、静脉药物滥用、锁骨骨折或锁骨下静脉插管。我们报告一例糖尿病患者在同侧肩部进行关节周围类固醇注射后发生胸锁关节化脓性关节炎的病例,据我们所知,迄今为止文献中尚未记载这种感染途径。我们回顾了有关已提出的流行病学及手术治疗方法的文献,并介绍了我们自己的手术经验。胸锁关节关节炎病例应始终怀疑有细菌感染。如果需要手术,必须记住,骨手术会使血管结构暴露在外,因此必须通过肌成形术进行覆盖。

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