It is a rare condition, most commonly seen in females of late childbearing age. By the time patients are diagnosed the condition and symptoms will have been present for months or years. The pain is described as intermittent or steady, but at times may be intense. Pain is usually localised to the medial end of the clavicle, but may radiate to the shoulder, neck and anterior chest wall. Movement of the shoulder is seldom restricted, but extreme flexion and abduction may aggravate the pain. A swelling over the medial clavicle is often present, with no overlying skin changes. Skin inflammation usually denotes an infection. Tenderness is mild. Bilateral involvement has not been reported.
Methods of treatment have included surgical excision (Brower et ab 1974; Petersen 1980; Appell et al 1983; Franquet et ab 1985), anti-inflammatory drugs (Weiner et al 1984), radiation (Appell et ab 1983; Cone et al 1983; Kruger et ab 1987) and antistaphylococcal antibiotics (Jones et al. 1990) with varying results.
Intermediate term follow up has shown that most of the pain settles over about six months, but the swelling and radiological changes persist (Sng et al 2004). No data exists for long term results.
Histology reveals thickened trabeculae, with both lamellar and woven components. Devitalised bone is present, suggesting remodelling. Periosteal reaction is often seen histologically.