Published online Aug 18, 2016. doi: 10.5312/wjo.v7.i8.494
Peer-review started: February 25, 2016
First decision: April 15, 2016
Revised: May 13, 2016
Accepted: June 1, 2016
Article in press: June 3, 2016
Published online: August 18, 2016
AIM: To confirm the rarity of this disorder and then to evaluate the effects of antibiotic treatment alone and assess whether this could produce a complete remission of symptoms in children and adolescents.
METHODS: We made a retrospective review of all cases of condensing osteitis of the clavicle in children and adolescents between January 2007 and January 2016. Outpatient and inpatient medical records, with radiographs, magnetic resonance imaging, triphasic bone scan and computed tomography scans were retrospectively reviewed. All the patients underwent biopsy of the affected clavicle and were treated with intra venous (IV) antibiotics followed by oral antibiotics.
RESULTS: Seven cases of condensing osteitis of the clavicle were identified. All the patients presented with swelling of the medial end of the clavicle, and 5 out of 7 reported persisting pain. The patients’ mean age at presentation was 11.5 years (range 10.5-13). Biopsy confirmed the diagnosis in all cases. All the patients completed the treatment with IV and oral antibiotics. At last follow-up visit none of the patients complained of residual pain; all had a clinically evident reduction in the swelling of the medial end of the affected clavicle. The mean follow-up was 4 years (range 2-7).
CONCLUSION: Our findings show that condensing osteitis of the clavicle is a rare condition. Biopsy is needed to confirm diagnosis. The condition should be managed with IV and oral antibiotics. Aggressive surgery should be avoided.
Core tip: Condensing osteitis of the clavicle is a rare benign disorder. It is characterized by pain and swelling at the medial end of the clavicle, with increased radio-density. Neither the etiology of this rare condition nor its treatment options are completely clarified. Condensing osteitis of the clavicle in children and adolescents should be recognized promptly. Biopsy is needed to confirm diagnosis. Once diagnosis is made, the condition should be treated by parenteral and oral antibiotic therapy, and aggressive surgery should be avoided.