Early Detection of Inflammation and Joint Destruction Revealed by Ultrasound in a Patient with Sternoclavicular Septic Arthritis

A 53-year-old Japanese man experienced fever/neck pain, and neck magnetic resonance imaging revealed a spinal epidural abscess. The following day, he developed a palpable mass with evident inflammatory signs in the right sternoclavicular joint (SCJ) with severe pain. Ultrasound revealed synovitis with remarkable power Doppler signals in the right SCJ. Blood cultures yielded Streptococcus agalactiae growth. After 12 days, ultrasound showed right distal clavicle bone erosion. His symptoms improved with long-term parenteral antibiotic treatment, but the right SCJ joint destruction progressed for several months. We diagnosed him with sternoclavicular septic arthritis complicated with a spinal epidural abscess and bacteremia.