Congenital Pseudoarthrosis of the Clavicle

Abstract

Introduction:  Congenital pseudarthrosis of the clavicle (CPC) presents as a congenital painless swelling over the mid-third of the clavicle, mostly on the right side and females, that persists over lifetime with no functional limitations.

Purpose: Present a 12 years follow-up case of CPC and literature review.

Clinical Case: A full-term newborn boy, with uncomplicated pregnancy and vaginal delivery, presented with a firm bony protuberance (1x1cm), in the mid-third of the right clavicle without functional limitations and no other physical examination abnormality. The X-ray identified a bony defect in the mid-third of the right clavicle with smooth, regular, intact/sclerotic cortex and without any evidence of callus formation. The diagnosis of CPC was performed.

Over the twelve follow-up years, he kept asymptomatic, without functional limitations and normal physical and skeletal development. Over time, the X-rays showed the same bone defect with the same characteristics. At fourth years old, surgery was proposed for aesthetic reasons but parents refused.

Conclusions:  Although rare, CPC can be easily diagnosed through characteristic physical examination findings and radiographic hallmarks. It is essential to exclude other differential diagnosis, like clavicular fracture or rare bone diseases, and be able to reassure parents, explaining the benign nature of this condition.