A case of strenoclavicular septic arthritis with mediastinitis managed conservatively and literature review

We present the case of a 66 year old diabetic female with left sided Sternoclavicular Joint (SCJ) Septic Arthritis (SA) who presented with atypical chest pain and reduced left shoulder movement. The case was initially misdiagnosed in the emergency department as a soft tissue injury of the shoulder. She re-presented a week later with fevers and raised inflammatory markers. The treating medical team had a high index of suspicion for a SCJ infection and investigated the patient in a timely manner. She was found to have left SCJ SA complicated by mediastinitis and abscess formation. Treatment consisted of intravenous antibiotics for 4 weeks, without any surgical intervention, followed by 8 weeks of oral antibiotics. The patient made a complete functional recovery. We present this case in detail and perform a review of the published literature regarding this rare entity.