Agarwal Archit, Maheshwari Rajesh
Department of Orthopaedics, Himalayan Institute of Medical Sciences, Dehradun, uttrakhand, India.
J Orthop Case Rep. 2014 Oct-Dec;4(4):51-3. doi: 10.13107/jocr.2250-0685.226.
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.
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.
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.
锁骨骨髓炎是一种罕见病症,在成年人中尤为如此。锁骨的大多数感染性病变是创伤性的,不难诊断。另一方面,非创伤性锁骨病变罕见且难以诊断。它也可能作为头颈外科手术和锁骨下导管置入的并发症出现。
我们描述了一名61岁男性的病例,他自两年前起左肩部尖端出现一个有脓性分泌物排出的窦道。临床放射学检查诊断该患者为锁骨外侧端化脓性骨髓炎。然而,活检证实其为结核性骨髓炎。
伴有继发感染的排脓窦道使得诊断困难并延误了恰当治疗。因此,由于骨结核可模仿任何骨病理情况,在鉴别诊断中必须考虑骨结核,尤其是在不常见部位。