Imaging of primary sternal osteomyelitis in a patient with Crohnʹs disease

A 41-year-old man with known Crohnʹs disease presented with chest pain and fever. Plain film and CT of the chest were normal, but bone scan and gallium scans showed intense sternal uptake. Surgery revealed staphylococcal osteomyelitis of the sternum. Following appropriate antibiotic treatment, the patientʹs symptoms resolved and follow-up gallium scans became normal. This is the first report of the association of sternal osteomyelitis and Crohnʹs disease, although other sites have been described. Sternal osteomyelitis has a high morbidity and the index of suspicion for this condition must be high even in the face of initially negative imaging.