Introduction: Sterno-clavicular joint (SCJ) infection accounts for 1% of all bone infections. Due to its anatomical location, SCJ infection may threaten the life prognosis. The aim of our study was to review the peculiarities of presentation and management of SCJ infection.

Methods: We retrospectively reviewed the records of 22 patients managed for SCJ infection between January 2005 and December 2022.

Results: The mean age of our patients was 58.8 years. Diabetes was the most frequent comorbidity reported in 11 cases. Four patients had chronic renal disease and were under dialysis. All the patients reported fever with a hot painful swelling of the SCJ, which was right sided in 14 cases. The swelling was extensive to the neck region in 3 cases and a skin fistula was observed in 1 case. Chest and neck CT-scan was performed in all cases. It showed features of destruction of the joint surfaces with intra-articular fluid collection and small bone fragments. Features of mediastinal involvement were found in 3 cases complicated with necrotizing mediastinitis. Pleural effusion was reported in 4 cases and lung abscess in 1 case. Among our patients, 19 underwent surgery. The procedure consisted in resection of the clavicular head and joint surfaces, with surgical drainage of all the purulent material and a thorough washing. The mean postoperative stay was 15 days.

Conclusion: Infection of the SCJ is often misdiagnosed due to its rarity.  Delay in diagnosis may lead to spread of the infection to the mediastinum and puts at risk the patient?s life prognosis. Therefore, in case of any clinical signs in the SCJ, infection should be ruled out at first.