Primary Sternal Tubercular Osteomyelitis: A Rare Cause of Chronic Chest Pain.

Sternal osteomyelitis is a rare clinical condition that occasionally develops when there is an adjacent focus of infection. However, primary sternal tubercular osteomyelitis is an extremely rare form. We describe the case of a 52-year-old Indian male who presented with a two-year history of central chest pain. The pain was not related to exercise, meals, or respiration. There was no history of cough, fever, or weight loss. On examination, there was tenderness over the sternum and the patient was diagnosed as having costochondritis. However, the patient's condition did not improve and he developed erythematous skin changes over the sternum. A computed tomography scan of the chest demonstrated destructive sternal lesions. Subsequently, a biopsy was taken which revealed the diagnosis of tuberculosis. The patient was managed by anti-tubercular therapy and had complete resolution of symptoms. Clinicians should keep this condition in the differential diagnosis of chronic chest pain mimicking the diagnosis of costochondritis, particularly in patients from endemic areas.