J Korean Acad Rehabil Med.  2000 Dec;24(6):1217-1222.

Poststreptococcal Reactive Arthritis in Sternoclavicular Joint: A case report

• Ahn KH
• Kim HS
• Hong JH
• Yun DH

Abstract

We report a patient with reactive arthritis induced by recent streptococcal infection. A 27 year man had suffered from fever, sore throat and pain on left sternoclavicular joint. Arthritis occurred two days after tonsillitis and involved left sternoclavicular joint. Left sternoclavicular joint showed redness, swelling and tenderness. There were no growth of microorganism in blood cultures, no evidence of group Abeta-streptococcus in throat cultures, but antistreptolysin-O (ASO) and c-reactive protein (CRP) serum titers were elevated in sequential monitoring. Bone scan showed focal hot uptake at left sternoclavicular joint and Gallium scan showed diffuse inflammation at left sternoclavicular joint and soft tissue biopsy around sternoclavicular joint showed mild chronic inflammation. We suspected septic arthritis and prescribed empirical antibiotics but his symptoms were wax and wane. From the poor responsiveness to antibiotics, sustained high titers of ASO and recent history of tonsillitis, we confirmed poststreptococcal reactive arthritis, and attempted high-dose anti-inflammatory drug (aspirin 6 gram). Left sternoclavicular and shoulder pain improved.

Keyword

Poststreptococcal reactive arthritis; Streptococcal infection; Sternoclavicular joint

MeSH Terms

Anti-Bacterial Agents
Arthritis
Arthritis, Infectious
Arthritis, Reactive*
Biopsy
C-Reactive Protein
Fever
Gallium
Humans
Inflammation
Palatine Tonsil
Pharyngitis
Pharynx
Shoulder Pain
Sternoclavicular Joint*
Streptococcal Infections
Tonsillitis
Anti-Bacterial Agents
C-Reactive Protein
Gallium