Tuberculous Osteolytic lesion of clavicle - Report of 4 cases

Introduction - Tuberculosis of the clavicle without involvement of the neighboring joints can be seen rarely. Most of the patients are children presenting with painful swelling of the clavicle associated with formation of cold abscess or sinuses. Treatment is essentially antitubercular drugs. Surgical excision may be rarely justified when diagnosis is uncertain or disease is unresponsive or for removal of a large sequestrum. Method - We had an opportunity to observe 4 patients with osteolytic lesion of the clavicle with or without the involvement of the neighboring joint. In our study there were 1 male patient and 3 female patients. They were investigated and the pathology of the lesions was evaluated. The incidence of the disease pathology and treatment outcome was analyzed.Results - All cases were diagnosed as Tuberculosis of clavicle histologically by open biopsy and were started with ATT emphorically. One case required only conservative management and further 3 cases required surgical intervention. From our study the incidence of osteolytic lesions of the clavicle is likely due to tuberculosis and they are easily treatable with ATT and certain surgical interventions. We found that, the prognosis was good in all cases. Management of osteolytic lesions of clavicle is undemanding, but appropriate diagnosis must be obtained through proper histological and radiological investigations. Any osteolytic lesions of clavicle should be considered as malignant unless proven, as the incidence of tuberculosis of clavicle which also presents as osteolytic lesion is very rare.