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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Non-Traumatic Clavicular Lesions in Children: Case Series and Literature Review

by
Federico Diomeda
1,
Rossella Greco
2,
Paola Lazzari
2,
Giulia Loiacono
1,
Manuela Taurisano
3,*,
Adina Pinna
1,
Francesco La Torre
4,
Alessandro Cocciolo
5,
Luca Giordano
6,
Flavia Indrio
7,
Arnaldo Scardapane
6,
Angelo Ravelli
8,9 and
Adele Civino
1
1
Reumatologia e Immunologia Pediatrica, Ospedale ‘Vito Fazzi’, 73100 Lecce, Italy
2
Dipartimento Interdisciplinare di Medicina, Università degli Studi di Bari ‘Aldo Moro’, 70121 Bari, Italy
3
Dipartimento di Scienze e Tecnologie Biologiche ed Ambientali, Università del Salento, 73100 Lecce, Italy
4
Centro di Reumatologia Pediatrica, Policlinico di Bari, 70124 Bari, Italy
5
Oncoematologia Pediatrica, Ospedale ‘Vito Fazzi’, 73100 Lecce, Italy
6
Radiologia Universitaria, Ospedale ‘Vito Fazzi’, 73100 Lecce, Italy
7
Pediatria Universitaria, Ospedale ‘Vito Fazzi’, 73100 Lecce, Italy
8
Direzione Scientifica, IRCCS Istituto Giannina Gaslini, 16147 Genova, Italy
9
Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DINOGMI), Università Degli Studi di Genova, 16126 Genova, Italy
*
Author to whom correspondence should be addressed.
Children 2026, 13(1), 112; https://doi.org/10.3390/children13010112
Submission received: 28 November 2025 / Revised: 31 December 2025 / Accepted: 1 January 2026 / Published: 12 January 2026
Versions Notes

Abstract

Background and objective: Clavicular pain and swelling in children can have multiple causes and often require a multidisciplinary approach. We aimed to describe the characteristics and final diagnoses of children with clavicular involvement and to review the literature on this topic. Methods: We retrospectively reviewed patients younger than 18 years who were evaluated for clavicular symptoms at two pediatric rheumatology centers and one pediatric oncohematology center. These data were then descriptively compared with findings from 63 patients reported across 7 published articles. Results: Twelve patients (9 females, median age 10 years [IQR 9.4–10.5]) were included. Final diagnoses were chronic nonbacterial osteomyelitis (CNO; 8), Langerhans cell histiocytosis (LCH; 2), reactive arthritis (1), and Tietze syndrome (1). Clavicular involvement was mostly unilateral and localized to the medial clavicle in CNO. The most frequent presenting symptom was local swelling (11/12), followed by pain (9/12). Diagnostic delay was a median of 4 months (IQR 1–10.5). Whole-body MRI revealed multifocal lesions in 6/8 CNO patients. Biopsy was often required for diagnosis primarily to exclude malignancy and to clarify atypical or unifocal presentations. The literature review confirmed CNO as the most frequent cause, followed by rare tumors. Conclusion: CNO predominates among pediatric non-traumatic clavicular lesions, but LCH and rare conditions are not uncommon, underscoring the need for careful differential diagnosis and targeted imaging.
Keywords: clavicle; non-traumatic clavicular lesions; chronic nonbacterial osteomyelitis (CNO); osteomyelitis; arthritis; bone lesions; whole-body MRI; pediatric rheumatology; clavicular pain; children clavicle; non-traumatic clavicular lesions; chronic nonbacterial osteomyelitis (CNO); osteomyelitis; arthritis; bone lesions; whole-body MRI; pediatric rheumatology; clavicular pain; children

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MDPI and ACS Style

Diomeda, F.; Greco, R.; Lazzari, P.; Loiacono, G.; Taurisano, M.; Pinna, A.; La Torre, F.; Cocciolo, A.; Giordano, L.; Indrio, F.; et al. Non-Traumatic Clavicular Lesions in Children: Case Series and Literature Review. Children 2026, 13, 112. https://doi.org/10.3390/children13010112

AMA Style

Diomeda F, Greco R, Lazzari P, Loiacono G, Taurisano M, Pinna A, La Torre F, Cocciolo A, Giordano L, Indrio F, et al. Non-Traumatic Clavicular Lesions in Children: Case Series and Literature Review. Children. 2026; 13(1):112. https://doi.org/10.3390/children13010112

Chicago/Turabian Style

Diomeda, Federico, Rossella Greco, Paola Lazzari, Giulia Loiacono, Manuela Taurisano, Adina Pinna, Francesco La Torre, Alessandro Cocciolo, Luca Giordano, Flavia Indrio, and et al. 2026. "Non-Traumatic Clavicular Lesions in Children: Case Series and Literature Review" Children 13, no. 1: 112. https://doi.org/10.3390/children13010112

APA Style

Diomeda, F., Greco, R., Lazzari, P., Loiacono, G., Taurisano, M., Pinna, A., La Torre, F., Cocciolo, A., Giordano, L., Indrio, F., Scardapane, A., Ravelli, A., & Civino, A. (2026). Non-Traumatic Clavicular Lesions in Children: Case Series and Literature Review. Children, 13(1), 112. https://doi.org/10.3390/children13010112

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