Condensing Osteitis

synonyms:

Condensing Osteitis ICD-9

Condensing Osteitis Etiology / Epidemiology / Natural History

• characterized by sclerosis and enlargement of the medial end of the clavicle with preservation of the sternoclavicular joint.
• Rare
• Generally women >40yrs old. Usually unilateral.
• Etiology unknown. May be secondary to chronic stress

Condensing Osteitis Anatomy

Condensing Osteitis Clinical Evaluation

• Tender swollen sternoclavicular joint.
• Symptoms generally worsened with shoulder abduction.

Condensing Osteitis Xray / Diagnositc Tests

• AP view, apical lordotic view, serendipity view. Difficult to view on plain films. Xrays demonstrate sclerosis and slight expansion of the medial 1/3 of the clavicle. Joint space preserved.
• CT scan: often helpful to demonstrate sclerosis and slight expansion of the medial 1/3 of the clavicle. Joint space preserved.
• MRI: demonstrates ossifcation of the marrow space. (Vierbloom MAC, Ann Rheum Dis 1992;51:539)
• Bone scan: demonstrates increase uptake in medial clavicle.
• Labs: ESR, CRP and WBC will be normal

Condensing Osteitis Classification / Treatment

• Generally responds well to ice, NSAIDs, activity modifications.
• Consider incisional or excisional biopsy if fails non-op treatment (Kruger GD, JBJS 1987;69A:550)

Condensing Osteitis Associated Injuries / Differential Diagnosis

• Paget's Disease
• Tietze’s syndrome
• Spontaneous sternoclavicular subluxation
• Seronegative Spondyloarthropathy
• Crystal deposition disease
• Sternoclavicular Septic Arthritis
• Sternoclavicular Hyperostosis
• Condensing Osteitis
• Friedrich’s disease (aseptic osteonecrosis)
• Rheumatoid arthritis

Condensing Osteitis Complications

• Generally benign.

Condensing Osteitis Follow-up Care

Condensing Osteitis Review References

• Higginbotham TO, JAAOS 2005;13:138

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