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Journal of the Korean Academy of Rehabilitation Medicine 2000;24(6):1217-1222.
Poststreptococcal Reactive Arthritis in Sternoclavicular Joint: A case report.
Ahn, Kyung Hoi , Kim, Hee Sang , Hong, Jang Hyeok , Yun, Dong Hwan
Department of Rehabilitation Medicine, Kyunghee University College of Medicine.
흉쇄관절에 생긴 연쇄상구균 감염 후 반응성 관절염 ⁣증례 보고⁣
안경회, 김희상, 홍장혁, 윤동환
경희대학교 의과대학 재활의학교실

We report a patient with reactive arthritis induced by recent streptococcal infection. A 27 year man had suffered from fever, sore throat and pain on left sternoclavicular joint. Arthritis occurred two days after tonsillitis and involved left sternoclavicular joint. Left sternoclavicular joint showed redness, swelling and tenderness. There were no growth of microorganism in blood cultures, no evidence of group A β-streptococcus in throat cultures, but antistreptolysin-O (ASO) and c-reactive protein (CRP) serum titers were elevated in sequential monitoring. Bone scan showed focal hot uptake at left sternoclavicular joint and Gallium scan showed diffuse inflammation at left sternoclavicular joint and soft tissue biopsy around sternoclavicular joint showed mild chronic inflammation. We suspected septic arthritis and prescribed empirical antibiotics but his symptoms were wax and wane. From the poor responsiveness to antibiotics, sustained high titers of ASO and recent history of tonsillitis, we confirmed poststreptococcal reactive arthritis, and attempted high-dose anti-inflammatory drug (aspirin 6 gram). Left sternoclavicular and shoulder pain improved.

Key Words: Poststreptococcal reactive arthritis, Streptococcal infection, Sternoclavicular joint


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