Osteitis condensans of the clavicle

Osteitis condensans of the clavicle is characterized by benign sclerosis of the inferomedial third of the clavicle. Its radiological appearance is homologous to that of the similarly-named osteitis condensans ilii, although no association has been reported.

Clinical presentation

It usually affects women of childbearing age. It can present with pain on the abduction of the arm and localized swelling. Unlike osteitis condensans ilii, it is usually unilateral.

Pathology

The syndrome seems to be a response to mechanical stress. Histology reveals thickened trabeculae, with both lamellar and woven components. Devitalised bone is present, suggesting remodeling. Periosteal reaction is often seen histologically.

Radiographic features

Plain radiograph and CT

Sclerosis of the inferior aspect of the medial third of the clavicle is seen, typically unilateral. It can sometimes be associated with a small osteophyte, but should never be associated with subchondral cysts, joint space narrowing or erosions.

Treatment and prognosis

It carries a good prognosis. Pain can usually be managed with anti-inflammatory drugs.

History and etymology

It was initially described by Brower, Sweet and Keats in 1974 .

Differential diagnosis

The differentials are those of a sclerotic clavicle and include:

• osteoarthritis
• SAPHO Syndrome
• tumors or tumor-like conditions
• Friedrich disease (avascular necrosis of the medial clavicle)
• sternoclavicular hyperostosis