Osteitis Condensans of the Clavicle

The medial end of the right clavicle is sclerotic and questionably enlarged.
The manubrium is unaffected and the sternal-manubrial joint is intact.
Findings may be more obvious on a detailed view.
This adult female patient is asymptomatic with regard to this incidental radiographic finding.

Radiography is compatible with Osteitis Condensans of the Clavicle.

You may wish to review some facts regarding this entity:

Typical patient is female, age 40, with history of stress to sternoclavicular joint (e.g. sports, lifting).
- True etiology unknown.
DDx includes:
- Ischemic necrosis --
  - Usually seen in children and adolescents s/p trauma or embolic event which interferes with blood supply to medial clavicular epiphysis.
  Sternocostoclavicular hyperostosis --
  - Seen in older pts., usually men.
  - Process is usually bilateral.
  - Affects sternum, clavicle, upper anterior ribs with S.T. Ca+2.
  - Often accompanied by pustules on palms and soles.
- Septic arthritis --
  - Destructive changes expected on both sides of joint.
  - Joint destruction.
- Osteoarthritis --
  - Affects both sides of joint.
  - Involves joint.
  - Typically, bilateral but asymmetric with osteophytic changes.
- Cleidometaphyseal osteomyelitis
  - Unusual syndrome in children and adolescents with symmetric lesions of tubular bones and clavicles.
  - Resembles sternocostoclavicular hyperostosis radiographically.

Ref: Resnick, D., Bone and Joint Imaging, W.B. Saunders, Philadelphia, PA, 1989, pp. 657-658.