J Korean Orthop Assoc.  2010 Jun;45(3):173-178. 10.4055/jkoa.2010.45.3.173.

Conservative Management of Condensing Osteitis of the Medial End of the Clavicle

• Kim YK
• Kim DW
• Kim DW

• KMID: 2185515
• DOI: http://doi.org/10.4055/jkoa.2010.45.3.173

Abstract

PURPOSE
To assess the clinical features and the outcomes of conservative treatment of condensing osteitis of the medial end of the clavicle. MATERIALS AND
METHODS
We reviewed 24 patients among 44 patients with pain and protrusion on the medial clavicle, who were diagnosed as condensing osteitis and followed over one year between April 2003 and August 2008. Plain radiograph and laboratory examination (24 cases), bone scan (12 cases), computed tomography (3 cases), MRI (1 case) and biopsy (1 case) were performed. Patients were followed with UCLA score, VAS (Visual Analogue Scale) and change of protrusion.
RESULTS
In all cases, mild sclerosis and expansion were seen at the medial clavicle and sternoclavicular joint was preserved. Laboratory examination showed nonspecific results but various abnormal findings. Protrusion was not changed in 20 cases (83%) and decreased in 4 cases (17%). VAS for pain was improved from 3.4 to 1.2 and VAS for function was improved from 25.5 to 29.1. UCLA score was improved from 28.8 points to 33.7 points.
CONCLUSION
Physical and radiologic examination was important for diagnosis of condensing osteitis and laboratory exmination was useful to differentiate it from other diseases. Conservative treatment with rest and nonsteroidal anti-inflammatory drugs showed satisfactory result.

Keyword

medial clavicle; condensing osteitis; clinical feature; conservative treatment

MeSH Terms

Biopsy
Clavicle
Humans
Osteitis
Sclerosis
Sternoclavicular Joint

Figure

• 

  Figure 1 Condensing osteitis of clavicle. (A) 57-year-old woman had pain in right medial clavicular region. Photograph shows swelling of sternal end of right clavicle. (B) Plain radiograph shows a sclerotic and irregular lesion in inferior aspect of right clavicular head (white arrow). (C) CT scan shows soft tissue swelling adjacent to it anteriorly (white arrow). (D) Scintigram shows increased uptake of tracer localized to sternal end of right clavicle.

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  Figure 2 Protrusion of medial clavicle in condensing osteitis. (A) 52-year-old woman who was diagnosed to condensing osteitis shows protrusion of right medial clavicle. (B) After 4 years, photography shows no change of protrusion.

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  Figure 3 Histopathology of condensing osteitis. (A) High power photomicrograph shows marrow fibrosis. (B) High power photomicrograph shows trabecular sclerosis and arcuate cement lines of mature, lamellar bone (H&E, ×200).

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