Poststreptococcal Reactive Arthritis in Sternoclavicular Joint: A case report.
- Author:
Kyung Hoi AHN
1
;
Hee Sang KIM
;
Jang Hyeok HONG
;
Dong Hwan YUN
Author Information
1. Department of Rehabilitation Medicine, Kyunghee University College of Medicine.
- Publication Type:Case Report
- Keywords:
Poststreptococcal reactive arthritis;
Streptococcal infection;
Sternoclavicular joint
- MeSH:
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
- From:Journal of the Korean Academy of Rehabilitation Medicine
2000;24(6):1217-1222
- CountryRepublic of Korea
- Language:Korean
-
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.
