Institute for Pain Medicine, Western Pennsylvania Hospital, Pittsburgh, PA 15224, USA.
Pain Physician. 2009 Nov-Dec;12(6):987-90.
Osteitis condensans of the sternoclavicular joint was first described by Brower et al in 1974. It is a rare benign disorder primarily affecting women of child-bearing age. Persistent pain and swelling in the medial part of the clavicle are the most common presenting symptoms and may represent an inflammatory process in the joint among other proposed etiologies. Radiological findings include sclerosis of the medial part of the clavicle and a normal sternoclavicular joint. Diagnosis is usually confirmed by biopsy. Pain management can be challenging in these patients. Multiple treatments have been described in the past including oral NSAIDS, physical therapy, radiation, surgical resection, and oral corticosteroids but have met with limited success. This case report describes the novel utility of sternoclavicular joint steroid injections in treating a patient with Osteitis condensans of the clavicle after failed medical therapy. Based on our clinical experience, and given the limited clinical success of other reported conservative treatment measures, a sternoclavicular joint injection under fluoroscopic guidance using a local anesthetic-corticosteroid injectate should be considered as a viable treatment option for pain associated with Osteitis condensans of the clavicle.
胸骨锁骨关节炎的骨硬化症于 1974 年由 Brower 等人首次描述。这是一种罕见的良性疾病，主要影响育龄妇女。锁骨内侧的持续性疼痛和肿胀是最常见的表现症状，除了其他提出的病因外，还可能代表关节的炎症过程。放射学表现包括锁骨内侧硬化和胸骨锁骨关节正常。通常通过活检来确诊。这些患者的疼痛管理具有挑战性。过去曾描述过多种治疗方法，包括口服非甾体抗炎药、物理治疗、放射治疗、手术切除和口服皮质类固醇，但效果有限。本病例报告描述了胸骨锁骨关节类固醇注射在治疗一名接受医学治疗失败的锁骨骨硬化症患者中的新用途。根据我们的临床经验，以及其他报告的保守治疗措施的有限临床成功，在透视引导下使用局部麻醉-皮质类固醇注射剂进行胸骨锁骨关节注射应被视为与锁骨骨硬化症相关的疼痛的可行治疗选择。
