Tuberculosis of the sternum and clavicle: imaging findings in 15 patients

Objective. To describe the imaging findings in sterno-clavicular tubercular involvement. Design and patients. Fifteen patients with pathologically proven tuberculos is of the sternum and clavicle were retrospectively evaluated. Routine radi ography, computed tomography (CT) and magnetic resonance imaging (MRI) were used in some or all of the patients. Clinical information and imaging feat ures were evaluated in each case. Results. Eight patients had sternoclavicular joint (SCJ) involvement, five had isolated sternal involvement and two had isolated clavicular involvemen t. Seven patients were evaluated with only CT, six with only MRI and two wi th both. There were eight male and seven female patients, varying in age be tween 16 and 78 years. Fever, swelling and pain were common presenting symp toms. Two patients were HIV positive. Radiographs were positive in only eig ht patients. Destruction and signal intensity (SI) changes of the sternum a nd clavicle, destruction of the cartilage, soft tissue changes representing granulation tissue/abscess, displacement of the adjacent structures (vesse ls, trachea, etc.) and inflammatory changes in the adjacent structures in t he form of cellulitis and myositis were common imaging features. Conclusions. All imaging methods can provide complementary information rega rding sterno-clavicular tubercular involvement that is helpful for determin ation of the therapy. MRI is useful in determining the extent of the lesion , particularly marrow involvement and soft tissue extent.