PMC6488687_01
(A) Anteroposterior X-ray image of the clavicle at the time of admission. (B) Sagittal and axial computed tomography of the clavicle.
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The radiograph revealed a fracture of the midshaft of the clavicle with no displacement or callus formation (Fig. 1A). Computed tomography (CT) confirmed the delayed union of the midshaft clavicular fracture with sclerotic, dull margins and ossification of the sternoclavicular joints (SCJ) and first costochondral junctions (Fig. 1B).
(A) Anteroposterior and lateral X-ray image of the lumbar spine, and (B) anteroposterior X-ray image of the pelvis.
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The radiograph of the lumbar spine and pelvis revealed that the lumbar spine had the characteristics of a bamboo spine with ankylosing changes (Fig. 2A), and the sacroiliac joints had grade 3 bilateral ankylosis (Fig. 2B), as defined by the modified New York radiological sacroiliitis criteria.
Bone scintigraphy. Anterior and posterior view of the whole body obtained before and after intravenous injection of 99mTc-methylene diphosphonate.
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Bone scintigraphy demonstrated an increasing uptake at the fracture lesion of the midshaft of the clavicle, sternoclavicular joint, sternal manubrium and body, and the right sacroiliac joint (Fig. 3).
Anteroposterior three-dimensional computed tomography of the clavicle included the sternoclavicular joints.
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A CT with three-dimensional reformatted images demonstrated hyperostosis of the bilateral SCJ (Fig. 4).
Anteroposterior X-ray image of the clavicle taken 10 months after the first admission.
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At the final follow-up visit 10 months after the first admission, consolidation was considered to be achieved with an increasing bridging callus and the disappearance of the fracture line on radiographs (Fig. 5).