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Increasing incidence of sternoclavicular joint infections in intravenous drug users
Hakan Orbay1, Sirivan Seng2, Daniel Kim3, Charles M. Geller1.
1CCMC, Upland, PA, USA, 2Sirivan Seng, Upland, PA, USA, 3Daniel Kim, Upland, PA, USA.

Objective:Sternoclavicular (SC) joint septic arthritis is more common among intravenous drug users (IVDU). Given the paucity of data in the literature, there is no widely accepted standardized treatment algorithm for this disease. We present a series of SC joint septic arthritis to help establish treatment guidelines.
Methods:A retrospective chart review was performed for all IVDU aged 18 or older with SC joint septic arthritis at our institution in 2019. The diagnosis was established by clinical manifestations and imaging findings. Cultures were obtained and microbiology was established using standard methodology.
Results:A total of four patients with SC joint septic arthritis were admitted during study period. All patients were male IVDU with an average age of 37 years old. Two of the patients were treated medically. Of the two that required surgical intervention, one underwent a limited incision and drainage and the other a more extensive debridement of the left clavicular head and a portion of the sternum. One patient developed a right brachial deep vein thrombosis postoperatively. Another patient returned to the operating room for an interval wash out. In two cases, Staphylococcus aureus was isolated from wound cultures. None of the patients suffered post-operative functional loss. All achieved complete resolution of the infection.
Conclusion:We anticipate that with the increasing rate of IVDU the incidence of SC joint septic arthritis will also increase. Currently, treatment modalities depend on an individual surgeonís clinical judgment. As more patients are studied, standardized data-driven guidelines will develop and evolve.


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