My first thought was that they should exclude gout, arthritis and then septic ( bacterial infection) arthritis. Have they done some blood tests? Apparently X/ray does not show much but CT or MR scan may be diagnostic.
Sternoclavicular joint septic arthritis manifesting as a neck abscess: a case report - Original Article
Ear, Nose & Throat Journal, August, 2003 by Atta Mohyuddin
The sternoclavicular joint is commonly involved in ankylosing spondylitis, degenerative arthritic conditions (i.e., rheumatoid arthritis and osteoarthritis), and primary and secondary metastatic conditions. Yood and Goldenberg reported that this joint was also involved in as many as 9% of cases of septic arthritis. (3) The differential diagnosis of a swollen sternoclavicular joint includes rheumatoid arthritis, osteoarthritis, Tietze's syndrome, rheumatic fever, gout, and tumors. (1) Risk factors for sternoclavicular joint infection include diabetes mellitus, rheumatoid arthritis, alcohol abuse, hemodialysis, trauma, and subclavian venipuncture. (4,5)
The onset of sternoclavicular joint infection is insidious, and the duration of clinical symptoms ranges from a few days to 2 months. (2) Pain on movement is present in the ipsilateral shoulder. Akkasilpa et al found that all 21 patients they studied exhibited fever and pain on shoulder movement during the course of their illness. (6) Fever is usually of low grade, and chills are absent. Our patient experienced shoulder pain, but no fever. An elevated erythrocyte sedimentation rate and a normal leukocyte count are usual, as was the case with our patient.
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