Brucellar joint involvement presented with chest pain.

A 45-year-old male stockbreeder presented to Sakarya Medical Faculty, Infectious Diseases Department, Turkey in December 2011 with progressive left chest pain on inspiration since last four months. He also had fever (38.7°C), sweats, chills and back pain. Suspecting brucellosis, he underwent brucella tube agglutination test which was found positive at 1/1280 titre. Chest X-ray was normal (Fig. 1), but bone scintigraphy revealed left sternoclavicular joint (SCJ) involvement (Figs 2, 3). With 90-day treatment of gentamicin, rifampicin and doxycycline treatment, he completely recovered. Brucellosis is an endemic zoonozis which can affect any organ or system1–3. Though osteoarticular involvement is common (45-60%), SCJ involvement is very rare (1-2%)4–6.

Fig. 1

Chest X-ray of the patient shows normal findings.

Fig. 2A-B

Anterior and posterior whole body scintigraphic image showing left SCJ involvement (arrow).

Fig. 3A-D

Bone scintigraphic image showing left SCJ involvement (arrows) due to brucellosis.