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Septic Arthritis of the Manubriosternal Joint in an Adolescent: A Case Report

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Septic arthritis of the manubriosternal joint is a rare condition, especially in adolescents, who often present with nonspecific symptoms that can mimic more common conditions such as musculoskeletal chest pain, costochondritis. Here, we report a case of septic arthritis in a 17-year-old girl and highlight the challenges in diagnosing and managing this condition in adolescents. Initially presenting with acute chest pain diagnosed as transient nonspecific chest pain, the patient's subsequent visits to the emergency department unveiled escalating symptoms, including high fever, prompting advanced imaging. Ultimately, the diagnosis of septic arthritis of the manubriosternal joint was confirmed, with blood culture growth revealing Methicillin-sensitive Staphylococcus aureus. Diagnostic delays have been attributed to the absence of typical symptoms and patient reluctance to be hospitalized. Our case emphasizes the importance of considering rare infectious etiologies in adolescents with chest pain and emphasizes the need for heightened suspicion in unusual anatomical sites. Further research is required to elucidate the pathogenesis and risk factors associated with this condition to aid in prompt diagnosis and treatment.

Abstract

Septic arthritis of the manubriosternal joint is a rare condition, especially in adolescents, who often present with nonspecific symptoms that can mimic more common conditions such as musculoskeletal chest pain, costochondritis. Here, we report a case of septic arthritis in a 17-year-old girl and highlight the challenges in diagnosing and managing this condition in adolescents. Initially presenting with acute chest pain diagnosed as transient nonspecific chest pain, the patient's subsequent visits to the emergency department unveiled escalating symptoms, including high fever, prompting advanced imaging. Ultimately, the diagnosis of septic arthritis of the manubriosternal joint was confirmed, with blood culture growth revealing Methicillin-sensitive Staphylococcus aureus. Diagnostic delays have been attributed to the absence of typical symptoms and patient reluctance to be hospitalized. Our case emphasizes the importance of considering rare infectious etiologies in adolescents with chest pain and emphasizes the need for heightened suspicion in unusual anatomical sites. Further research is required to elucidate the pathogenesis and risk factors associated with this condition to aid in prompt diagnosis and treatment.

참고문헌 (8)

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  2. Okubo Y, "Nationwide survey of pediatric septic arthritis in the United States", J Orthop, 14, pp.342~346 (2017)
  3. Arnold JC, "Osteoarticular infections in children", Infect Dis Clin North Am, 29, pp.557~574 (2015)
  4. Sarcinelli JM, "Manubriosternal joint : synchondrosis or symphysis? Analysis of morphology and aging in humans", Surg Radiol Anat, 41, pp.275~279 (2019)
  5. Carnevale A, "Primary septic arthritis of the manubriosternal joint in an immunocompetent young patient : a case report", Radiol Case Rep, 12, pp.682~685 (2017)
  6. O’Connor A, "Septic arthritis of the manubriosternal joint presenting as a chest-wall swelling in an immunocompetent patient", J Surg Case Rep, 2019, pp.rjz261~ (2019)
  7. Sorek A, "Rib Osteomyelitis in pediatric patients-case series and literature review", Pediatr Infect Dis J, 41, pp.e506~e509 (2022)
  8. Woods CR, "Clinical practice guideline by the Pediatric Infectious Diseases Society(PIDS)and the Infectious Diseases Society of America(IDSA) : 2023 guideline on diagnosis and management of acute bacterial arthritis in pediatrics", J Pediatric Infect Dis Soc, 13, pp.1~59 (2024)

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