Ribs / Chest Wall
Sternoclavicular Joint Dysfunction
흉쇄관절 기능장애
Focal pain/dysfunction from SC joint subluxation or osteoarthritis
- How common
- Uncommon (often underdiagnosed)
- Typical age
- All ages (trauma young, OA elderly)
What is it?
Traumatic subluxation or chronic osteoarthritis of SC joint causes malalignment, pain, and restricted motion.
Commonly affected: Sternoclavicular joint — posterior dislocation is emergency
How it develops
- TriggerTrauma, overuse, rheumatic, infection
- Capsule/Ligament InjuryAnterior subluxation most common
- Cartilage WearChronic cases develop OA
- Pain/ROM LimitationPain with abduction/elevation
Symptoms
- Local pain/swellingPain/swelling over SC joint
- Arm motion limitationWorse with abduction/elevation
- Visible joint prominenceProminence seen in anterior subluxation
- Clicking/crepitusJoint noise with motion
- Shoulder stiffnessReferred shoulder stiffness
How it is examined
- Joint palpationTenderness/swelling at SC joint
- Joint alignmentAnterior prominence vs posterior depression
- Arm motion testingPain/restriction with abduction/elevation
- Neurovascular examCheck for great vessel/airway compromise in posterior dislocation
Imaging
Plain X-ray often non-diagnostic due to overlapping structures; serendipity view may help.
- Possible malalignment
- Limited by structural overlap
- Consider serendipity view
CT is best for SC joint — axial cuts show subluxation or OA; essential for posterior dislocation.
- CT: anterior/posterior displacement
- Joint narrowing/osteophytes
- MRI: capsular inflammation/edema
Non-surgical care
- Activity modification/slingAcute-phase upper-limb rest
- NSAIDsInflammation/pain control
- Physical therapyShoulder girdle stabilization, posture
- Intra-articular injectionImage-guided steroid/hyaluronic injection
Conservative options are generally tried first. Medications listed here can have side effects — discuss them with your prescriber.
When surgery is considered
Posterior dislocation (emergency), failed conservative, severe instability
Procedures that may be discussed
- Closed reduction
- Joint reconstruction / medial clavicle resection
Outlook
Most respond to conservative care; posterior dislocation is surgical emergency.