Advertisement

Imaging of primary sternal osteomyelitis in a patient with Crohn's disease

      Abstract

      A 41-year-old man with known Crohn's disease presented with chest pain and fever. Plain film and CT of the chest were normal, but bone scan and gallium scans showed intense sternal uptake. Surgery revealed staphylococcal osteomyelitis of the sternum. Following appropriate antibiotic treatment, the patient's symptoms resolved and follow-up gallium scans became normal. This is the first report of the association of sternal osteomyelitis and Crohn's disease, although other sites have been described. Sternal osteomyelitis has a high morbidity and the index of suspicion for this condition must be high even in the face of initially negative imaging.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Clinical Imaging
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Bryan RT
        • Noor S
        • Quraishi S
        • Bradish CF
        • Parkh D
        Primary sternal osteomyelitis in infants: a report of two cases.
        J Pediatr Orthop. 1999; 8: 125-126
        • Heaton PA
        • Humphries N
        Primary sternal osteomyelitis.
        Pediatr Infect Dis J. 1995; 14: 722-723
        • Shah M
        • Watanakunakorn C
        Staphylococcus aureus sternal osteomyelitis complicating bone marrow aspiration.
        South Med J. 1978; 71: 348-349
        • Tabib W
        • Banallee L
        • Rehel P
        • Cottin P
        Primary acute osteomyelitis of the sternum associated with anterior mediastinitis.
        J Chir (Paris). 1996; 133: 20-22
        • Cobo J
        • Aguado JM
        • Cortina J
        • Cobo P
        • del Hierro M
        Infection of sternal wound in heart surgery: analysis of 1000 operations.
        Med Clin (Barc). 1996; 106: 401-404
        • Boll KL
        • Jurik AG
        Sternal osteomyelitis in drug addicts.
        J Bone Jt Surg, Br Vol. 1990; 72: 328-329
        • Blokh I
        • Sobti P
        • Zinn H
        • Burak J
        • Ajiboye P
        • Solomon W
        A rare case of osteomyelitis of the sternum in an adult with sickle cell disease.
        Hemoglobin. 2001; 25: 111-113
        • Kotilainnen P
        • Merilahti-Palo R
        • Lehtonen OP
        • Manner I
        • Helander I
        Propionibacterium acnes isolated from sternal osteitis in a patient with SAPHO syndrome.
        J Rheumatol. 1996; 23: 1302-1304
        • Bianchi R
        • Chekikian G
        • Ciboddo G
        • Ciceri F
        • Sbriscia Fioretti E
        • Rugarli C
        Primary sternal osteomyelitis by Aspergillus fumigatus.
        Br J Rheumatol. 1994; 33: 994-995
        • Sullivan TR
        • Dale GG
        • Baida M
        Primary osteomyelitis of the sternum due to Salmonella hirschfeldii.
        Can J Surg. 1981; 24: 81-82
        • Narchi H
        Primary sternal osteomyelitis in children with sickle cell disease.
        Pediatr Infect Dis J. 1999; 18: 940-942
        • McLellan DG
        • Phillips KB
        • Corbett CE
        • Bronze MS
        Sternal osteomyelitis caused by Mycobacterium tuberculosis: case report and review of the literature.
        Am J Med Sci. 2000; 319: 250-254
        • Schwartz CM
        • Demos TC
        • Wehner JM
        Osteomyelitis of the sacrum as the initial manifestation of Crohn's.
        Clin Orthop. 1987; 222: 181-185
        • Chandler JT
        • Riddle CD
        Osteomyelitis associated with Crohn's disease. A case report and literature review.
        Orthopedics. 1989; 12: 285-288
        • Freeman HJ
        Osteomyelitis and osteonecrosis in inflammatory bowel disease.
        Can J Gastroenterol. 1997; 11: 601-606
        • Mittapalli MR
        Value of bone scan in primary sternal osteomyelitis.
        South Med J. 1979; 72: 1603-1604
        • Gold RH
        • Hawkins RA
        • Katz RD
        Bacterial osteomyelitis: findings on plain radiography, CT, MR, and scintigraphy.
        Am J Roentgenol. 1991; 157: 365-370
        • Schauwecker DS
        • Park HM
        • Mock BH
        • Burt RW
        • Kernick CB
        • Ruoff AC
        Evaluation of complicating osteomyelitis with Tc-99m MDP, In-111 granulocytes, and Ga-67 citrate.
        J Nucl Med. 1984; 25: 849
        • Bessette PR
        • Hanson MJ
        • Czarnecki DJ
        • Yuille DL
        • Rankin JJ
        Evaluation of postoperative osteomyelitis of the sternum comparing CT and dual Tc-99m MDP bone and In-111 WBC SPECT.
        Clin Nucl Med. 1993; 18: 197-202
        • Rosenthall L
        • Kloiber R
        • Damtew B
        • Kloiber R
        Sequential use of radiophosphate and radiogallium imaging in the differential diagnosis of bone, joint and soft tissue infection: quantitative analysis.
        Diagn Imaging. 1982; 51: 249
        • Smith PS
        • Peterson RJ
        • Ferlic RM
        Gallium scan in sternal osteomyelitis.
        Am J Roentgenol. 1979; 132: 840-841
        • Lew DP
        • Waldvogel FA
        Osteomyelitis.
        N Engl J Med. 1997; 336: 999-1007
        • Gylys-Morin VM
        MR imaging of pediatric musculoskeletal inflammatory and infectious disorder.
        Magn Reson Imaging Clin N Am. 1998; 6: 537-559