Retrospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Aug 18, 2016; 7(8): 494-500
Published online Aug 18, 2016. doi: 10.5312/wjo.v7.i8.494
Condensing osteitis of the clavicle in children
Antonio Andreacchio, Lorenza Marengo, Federico Canavese
Antonio Andreacchio, Lorenza Marengo, Department of Pediatric Orthopedic Surgery, Regina Margherita Children’s Hospital, 10100 Torino, Italy
Federico Canavese, Department of Pediatric Surgery, University Hospital Estaing, 63003 Clermont Ferrand, France
Author contributions: Andreacchio A and Canavese F designed and performed the research and wrote the paper; Marengo L contributed to the analysis and revised the text.
Institutional review board statement: The study was reviewed and approved by the local Institutional Review Board (Comité de Protection des Personnes Sud-Est 6; ref. 2016/CE01).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Federico Canavese, MD, PhD, Professor of Pediatric Orthopedic Surgery, Department of Pediatric Surgery, University Hospital Estaing, 1 place Lucie et Raymond Aubrac, 63003 Clermont Ferrand, France. canavese_federico@yahoo.fr
Telephone: +33-4-73750293 Fax: +33-4-73750291
Received: February 23, 2016
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
Processing time: 176 Days and 4.2 Hours
Abstract

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.

Keywords: Condensing osteitis; Clavicle; Children; Benign tumor; Infection

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.