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Sternoclavicular Joint Injury Differential Diagnoses

  • Author: John P Rudzinski, MD, FACEP; Chief Editor: Trevor John Mills, MD, MPH  more...
 
Updated: Nov 24, 2015
 
 

Differential Diagnoses

 
 
Contributor Information and Disclosures
Author

John P Rudzinski, MD, FACEP Clinical Professor of Surgery, Department of Surgery, Clinical Professor of Medicine, Department of Internal Medicine, University of Illinois College of Medicine; Visiting Professor, American University of the Caribbean; Vice-Chairman, Emergency Department, Director of Medical Education, Rockford Health System; Staff Physician, Emergency Department, Rockford Memorial Hospital

John P Rudzinski, MD, FACEP is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

Alina Perez University of Illinois College of Medicine at Rockford

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

David B Levy, DO, FAAEM Senior Consultant in Emergency Medicine, Waikato District Health Board, New Zealand; Associate Professor of Emergency Medicine, Northeastern Ohio Universities College of Medicine

David B Levy, DO, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, Fellowship of the Australasian College for Emergency Medicine, American Medical Informatics Association, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Trevor John Mills, MD, MPH Chief of Emergency Medicine, Veterans Affairs Northern California Health Care System; Professor of Emergency Medicine, Department of Emergency Medicine, University of California, Davis, School of Medicine

Trevor John Mills, MD, MPH is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians

Disclosure: Nothing to disclose.

Additional Contributors

Daniel J Dire, MD, FACEP, FAAP, FAAEM Clinical Professor, Department of Emergency Medicine, University of Texas Medical School at Houston; Clinical Professor, Department of Pediatrics, University of Texas Health Sciences Center San Antonio

Daniel J Dire, MD, FACEP, FAAP, FAAEM is a member of the following medical societies: American Academy of Clinical Toxicology, American Academy of Pediatrics, American Academy of Emergency Medicine, American College of Emergency Physicians, Association of Military Surgeons of the US

Disclosure: Nothing to disclose.

References
  1. Lee JT, Campbell KJ, Michalski MP, Wilson KJ, Spiegl UJ, Wijdicks CA, et al. Surgical anatomy of the sternoclavicular joint: a qualitative and quantitative anatomical study. J Bone Joint Surg Am. 2014 Oct 1. 96 (19):e166. [Medline].

  2. Torretti J, Lynch SA. Sternoclavicular joint injuries. Curr Opin Orthop. 2004. 15(4):242-7.

  3. Albarrag MK. Bilateral asymmetrical traumatic sternoclavicular joint dislocations. Sultan Qaboos Univ Med J. Nov 2012. 12(4):512-516. [Medline]. [Full Text].

  4. Fenig M, Lowman R, Thompson BP, Shayne PH. Fatal posterior sternoclavicular joint dislocation due to occult trauma. Am J Emerg Med. 2010 Mar. 28(3):385.e5-8. [Medline].

  5. Chotai PN. Posterior sternoclavicular dislocation presenting with upper-extremity deep vein thrombosis. Orthopedics. Oct/2012. 35(10): e1542-7:[Medline].

  6. Friedman RS, Perez HD, Goldstein IM. Septic arthritis of the sternoclavicular joint due to gram-positive microorganisms. Am J Med Sci. 1981 Sep-Oct. 282(2):91-3. [Medline].

  7. Womack J. Septic arthritis of the sternoclavicular joint. J Am Board Fam Med. 2012 Nov-Dec. 25 (6):908-12. [Medline].

  8. Marcus MS, Tan V. Cerebrovascular accident in a 19-year-old patient: a case report of posterior sternoclavicular dislocation. J Shoulder Elbow Surg. 2011 Oct. 20(7):e1-4. [Medline].

  9. Kirby JC, Edwards E, Kamali Moaeveni A. Management and functional outcomes following sternoclavicular joint dislocation. Injury. Oct 2015. 46(10):1906-1913. [Medline]. [Full Text].

  10. Garretson RB 3rd, Williams GR Jr. Clinical evaluation of injuries to the acromioclavicular and sternoclavicular joints. Clin Sports Med. 2003 Apr. 22(2):239-54. [Medline].

  11. Ernberg LA, Potter HG. Radiographic evaluation of the acromioclavicular and sternoclavicular joints. Clin Sports Med. 2003 Apr. 22(2):255-75.

  12. McCulloch P, Henley BM, Linnau KF. Radiographic clues for high-energy trauma: three cases of sternoclavicular dislocation. AJR Am J Roentgenol. 2001 Jun. 176(6):1534. [Medline].

  13. Brinker MR, Simon RG. Pseudo-dislocation of the sternoclavicular joint. J Orthop Trauma. 1999 Mar-Apr. 13(3):222-5. [Medline].

  14. Ferri M, Finlay K, Popowich T, Jurriaans E, Friedman L. Sonographic examination of the acromioclavicular and sternoclavicular joints. J Clin Ultrasound. 2005 Sep. 33(7):345-55. [Medline].

  15. Benson LS, Donaldson JS, Carroll NC. Use of ultrasound in management of posterior sternoclavicular dislocation. J Ultrasound Med. 1991 Feb. 10(2):115-8. [Medline].

  16. Glass ER, Thompson JD, Cole PA, Gause TM 2nd, Altman GT. Treatment of sternoclavicular joint dislocations: a systematic review of 251 dislocations in 24 case series. J Trauma. 2011 May. 70(5):1294-8. [Medline].

  17. Yeh GL, Williams GR. Conservative management of sternoclavicular injuries. Orthop Clin North Am. 2000 Apr. 31(2):189-203. [Medline].

  18. Balcik BJ, Monseau AJ, Krantz W. Evaluation and treatment of sternoclavicular, clavicular, and acromioclavicular injuries. Prim Care. 2013 Dec. 40 (4):911-23, viii-ix. [Medline].

  19. MacDonald, P., Lapointe, P. Acromioclavicular and Sternoclavicular Joint Injuries. Orthopedic Clinics of North America. 10/08. 39:[Full Text].

  20. Tepolt F, Carry PM, Taylor M, Hadley-Miller N. Posterior sternoclavicular joint injuries in skeletally immature patients. Orthopedics. 2014 Feb. 37 (2):e174-81. [Medline].

  21. Tepolt F, Carry PM, Heyn PC, Miller NH. Posterior sternoclavicular joint injuries in the adolescent population: a meta-analysis. Am J Sports Med. 2014 Oct. 42 (10):2517-24. [Medline].

  22. Gobet R, Meuli M, Altermatt S, et al. Medial clavicular epiphysiolysis in children: the so-called sterno-clavicular dislocation. Emerg Radiol. 2004 Apr. 10(5):252-5. [Medline].

  23. Van Hofwegen C, Wolf B. Suture repair of posterior sternoclavicular physeal fractures: a report of two cases. Iowa Orthop J. 2008. 28:49-52. [Medline].

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This 80-year-old woman presented 1 week after a fall because of persistent pain and discoloration in the anterior part of her chest. Certain movements of her right arm were especially painful though not incapacitating. Note the extensive ecchymosis of the anterior part of her thorax and the swelling of the right upper parasternal/lower anterior neck area. The right sternoclavicular joint area was tender and edematous to palpation.
Superior mediastinal contents may be threatened in posterior dislocations of the sternoclavicular joint.
CT scan of a left sternoclavicular dislocation demonstrates anterior and superior displacement of the clavicle from its normal articulation with the manubrium. The right sternoclavicular joint is normal.
CT scan of a left sternoclavicular dislocation demonstrates anterior and superior displacement of the clavicle from its normal articulation with the manubrium. The right sternoclavicular joint is normal.
CT scan of a left sternoclavicular dislocation demonstrates anterior and superior displacement of the clavicle from its normal articulation with the manubrium. The right sternoclavicular joint is normal.
The right sternoclavicular joint appears edematous on lateral inspection. Palpation confirms the apparent anterior dislocation.
Comparison of the normal left sternoclavicular joint emphasizes the abnormalities.
The patient refused further workup and treatment beyond a temporary sling, stating that the injury had not significantly affected her lifestyle. She was discharged home in the company of her daughter with over-the-counter analgesics.
 
 
 
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