Sternocostoclavicular hyperostosis scintigraphic evaluation

Sternocostoclavicular hyperostosis (SCCH) is a condition characterized by pain and swelling in the upper anterior chest wall. It is a chronic aseptic destructive sternocostoclavicular arthritis with nonspecific laboratory findings. On radiographic examination, hyperostotic changes of the stemoclavicular region can be seen. Bone scintigraphy is sensitive and specific in demonstrating abnormal radiotracer activity in a characteristic bullhorn-like pattern, which has led to the term bullhorn sign. When this is encountered, SCCH is an important differential diagnosis to consider to avoid a misdiagnosis and to differentiate the condition from a malignant process.