Sternocostoclavicular Joint Swelling; Diagnosis of a Neglected Entity

Background:  Sternocostoclavicular joint (SCCJ) swelling is an underdiagnosed, albeit important entity in clinical practice. The present study was conducted in order to identify the incidence and common causes of this entity.  Methods:  Patients presenting to the Orthopaedic Clinic with a swelling of the sternocostoclavicular joint, during the study period of two years were included, and detailed history was obtained from the patient. Baseline investigations (total and differential leukocyte count, ESR, CRP, X-ray and CT) wereperformed. Magnetic resonance imaging,FNAC or joint aspiration was performed whenever clinically or radiologically indicated.  Results:   A total of 21 patients were enrolled into the study for a duration of 2 years. Patients mainly presented with both pain and swelling of the SCCJ with predominant right sided involvement. Osteoarthritis was the most frequent diagnosis followed by infections, primary bone/cartilage tumor, and metastasis.  Conclusions:  Although most of the patients with SCCJ swelling have a benign etiology, it is not wise to dismiss thisswelling as degenerative changes. Serious conditions like septic arthritis or neoplasia, may masquerade with similar presentations such as osteoarthritis. It would be therefore imperative to rule out all of these potentially life threatening conditions using thorough clinic-radiological workups.