14/01/2026
☢️ Sternal infection ☢️ 51-year-old male with history of CABG and post operative sternal dehiscence and wound infection. Sternal reconstruction and fixation was done; however, over the next few weeks, he developed a draining sinus from the sternal wound. FDG PET images clearly show hypermetabolic soft tissue collection with indistinct margins and gas locales centered at the midline sternotomy, with trans-sternal extension both anteriorly to the subdermis and posterior into the anterior mediastinum approaching the pericardium. The regional fat planes are infiltrated with fat stranding and increased opacification. There is also hypermetabolic activity in the sternoclavicular joint spaces with bone resorption of the manubrial and clavicular ends of sternoclavicular joints suggestive of underlying infection.
🗓 The probability of median sternotomy complications is around 5% with mortality rate reaching up to 80%. Complications can be divided into presternal (cellulitis, abscess, sinus fistula), sternal (dehiscence, osteomyelitis), mediastinal (abscess, mediastinitis). Variable SN and SP have been reported for FDG PET/CT in MSK infections. For example the reported the SN and SP in chronic osteomyelitis is 92%, in diabetic foot (vs. Charcot joint) 74% and 91%. Nevertheless, sternal infections share a similar process as in a different anatomical region.
