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Results for “STERNOCLAVICULAR JOINT”

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At least 289 records · Page 16Linked to original sources

PubMed1979

Radiology of postnatal skeletal development. III. The clavicle.

Thirty-one pairs of clavicles obtained from human cadavers ranging in age from full-term stillborn to fourteen years were studied morphologically and radiographically. Specimen roentgenography using air/cartilage interfacing demonstrated the osseous and cartilaginous portions of the epiphyses. Overall longitudinal growth appeared to occur to a greater degree in the sternal end, which also developed a secondary ossification center. No comparable ossification was seen in the acromion. The curve patterns differed in the acromial and sternal ends. The sternoclavicular joint has a meniscus throughout postnatal development. This was demonstrated by air arthrography. Finally, the sternoclavicular joint was dislocated anteriorly and posteriorly to duplicate trauma to this region. Roentgenographic aspects of development are discussed and illustrated to provide a reference index.

Adolescent↗

PubMedDate not supplied

Retrosternal epiphyseal disruption of medial clavicle: case and review in children.

Retrosternal dislocations of the clavicle have been reported previously in adults throughout the orthopedic literature. However, in children few cases have been noted in either the pediatric, emergency, or orthopedic literature. The potential for great vessel injury as well as acute airway compromise makes the retrosternal disruption of the sternoclavicular joint a surgical emergency that must be diagnosed quickly. Diagnosis is enhanced by the cephalic tilt view and by computed tomography (CT scan), as planar x-ray and tomography do not always reveal this potentially life-threatening condition. Surgical consultation must be sought acutely; however, management may need to begin prior to definitive repair. Emergency management begins by suspecting the injury, and with immediate airway and circulatory support for the patient.

Adolescent↗

PubMed2005

Stress fracture of the clavicle associated with sternocostoclavicular hyperostosis.

We report a case of stress fracture of the clavicle associated with sternocostoclavicular hyperostosis. A 60-year-old man sustained a stress fracture of the right clavicle with no history of trauma. On radiography, hyperostosis of the anterior chest wall and ankylosis of the sternoclavicular joint were evident in addition to the fracture. Fracture healing was uneventful after 2.5 months. Ankylosis of the sternoclavicular joint may have caused increased stress at the midshaft of the clavicle by daily activity or minor trauma. Such a fracture is a rare complication of sternocostoclavicular hyperostosis.

Ankylosis↗

PubMedDate not supplied

[Inflammatory rheumatic disorders during the course of secondary syphilis (author's transl)].

A 46-year-old man presented signs of secondary syphilis, including a skin eruption, multiple adenopathies, and alopecia. The diagnosis was confirmed by positive serological and Nelson's tests. Inflammatory arthritic signs developed in a few joints two weeks after the onset of the skin eruption, affecting mainly the left wrist, right sternoclavicular joint, lumbar spine, and right shoulder and hip joints, which were painful and stiff. Tests for a rheumatic origin, especially urethral smears and HLA B27 antigen, were negative. The articular manifestations disappeared completely after 8 to 10 days of penicillin. Rheumatic disorders from secondary syphilis affect one or several of the large joints, and quite frequently the sternoclavicular joints, the clinical, radiological, and biological characteristics showing no particular features. Diagnosis is based on the exclusion of other causes for the rheumatic disorder, total rapid regression after penicillin alone, and the simultaneous appearance of the affections.

Adult↗

PubMed1988

Asymptomatic innominate vein tamponade with retromanubrial clavicular dislocation. A case report.

Traumatic sternoclavicular joint dislocations are uncommon and posterior dislocations are rare; however, reports in the orthopaedic literature focus predominantly on retrosternal dislocations owing to their potentially dangerous sequelae. We report a case of asymptomatic complete innominate vein obstruction secondary to retromanubrial dislocation of the sternoclavicular joint with restoration of flow after closed reduction.

Adolescent↗

PubMed1993

99mTc-MDP scintigraphy in ankylosing spondylitis.

99mTechnetium-MDP bone scintigrams in 11 patients with ankylosing spondylitis were reviewed. Increased activity in sacroiliac joints was present in five of 11 cases, all of whom had symptoms of less than 5 years duration. Patients with longstanding disease had normal or low sacroiliac joint activity. In the spine, appearances included diffuse symmetrical, unifocal or multifocal asymmetrical increased uptake involving the costovertebral, costotransverse and facet joints as well as the spinous processes. In advanced disease with extensive ankylosis, the lumbar spine was featureless on scintigraphy, except for focal increased activity at the site of previous fracture in one patient. Of six available views of the sternum, increased uptake was present in five at the manubriosternal joint and five at the sternoclavicular joints. Increased peripheral uptake was mainly in the hips and knees in advanced cases. Plain radiographic changes correlated poorly with scintigraphic changes, scintigraphy detecting considerably more lesions than radiography. Awareness of the scintigraphic appearances of ankylosing spondylitis may lead to diagnosis before the development of radiographic changes and avoid confusion with other pathology. Clinical indications for bone scintigraphy in ankylosing spondylitis are suggested.

Adult↗

PubMed1991

[kinematic consideration of the shoulder girdle and its consequences on common surgical methods].

Motility of the upper extremities is the sum of movements of an open kinematic chain made up of the hands and the lower and upper arms in the humero-scapular joints which are integrated in the closed kinematic chains of the bilateral symmetrical shoulder girdles. Each shoulder girdle assembles three kinematic links (scapula, clavicle, hemithorax), with three joints (sternoclavicular, acromioclavicular, thoraco-scapular), creating a three-bar linkage. This linkage may be characterized as an effective transformer of motion with 11 degrees of freedom ensuring wide ranges of motions. This motion-transformer acts strictly as a guided linkage, allowing a precise reference between initial motion and functional result. The operative transfixation of acromioclavicular joints in the case of either dislocation or arthrodesis, also of the sternoclavicular joint reduces the degree of kinematic freedom from 11 to 8 and alters the shoulder as a motion-transformer into a rigid girdle with a variable length of support, with degeneration of the shoulder linkage. Surgical treatment of acromioclavicular dislocation with coraco-clavicular fusion using a screw as described by Bosworth produces osseus strain and a girdle under twofold static in determination (F = -2) with pressure forces causing bone deformation, loosening of the screw and fatigue fractures. This operation therefore cannot yet be recommended. Additional cadaver experiments with means of strain gauge cells have shown that lengthening of the clavicle by 0.5 cm increases the forces transmitted from the elevated arm to the hemithorax by 16%. Shortening of the osteotomized clavicle by only 1 cm leads to an increase of these forces by about 40%.(ABSTRACT TRUNCATED AT 250 WORDS)

Acromioclavicular Joint↗

PubMed2000

[Traumatic sternoclavicular instability. A therapeutic alternative].

Traumatic instability of the sternoclavicular joint is a rare diagnosis. It is usually treated by different bandaging techniques without the possibility of early functional aftercare. In the period between 1 January 1996 and 31 December 1998, a total of eight patients with unstable sternoclavicular joints requiring surgical treatment were treated with Balser plates. The population comprised seven anterior and one posterior dislocations. The results achieved with this alternative treatment option, which offers the advantage of enabling early functional aftercare, are presented. Seven of eight patients were available for follow-up. The eighth patient moved from the area. The Constant Score ranged between 84 and 100 points (average 89 +/- 6.6).

Adolescent↗

PubMed2000

Intrathoracic migration of Kirschner pins.

We report two cases of intrathoracic migration of Kirschner pins used for the treatment of sternoclavicular joint dislocation. The migration was asymptomatic in both cases. Treatment involved median sternotomy in one patient and video-assisted thoracoscopy in the other. A favorable outcome was observed in both patients. The reports confirm the potential dangers related to management of sternoclavicular joint dislocation with metallic fixation devices.

Adult↗

PubMedDate not supplied

Staphylococcal mediastinitis due to sternoclavicular pyarthrosis: CT appearance.

Three cases of acute mediastinitis secondary to staphylococcal sternoclavicular pyarthrosis are reported. In each case, the patient presented with minimal signs and symptoms and mediastinitis was not suspected until demonstrated by preoperative CT. Since septic arthritis of the sternoclavicular joint may be insidious in onset and is associated with a high incidence of life-threatening secondary mediastinitis, CT is recommended as the initial imaging study in the evaluation of unexplained sternoclavicular joint pain and swelling.

Arthritis, Infectious↗

PubMed1978

Traumatic sternoclavicular dislocation.

Traumatic dislocations of the sternoclavicular joint may be anterosternal or retrosternal. Anterior dislocation is due to forces which retract and depress the clavicle. Posterior dislocation is due to either direct force on the medial end of the clavicle or to a force acting on the posterolateral aspect of the shoulder. From 1950 to 1974 we treated 16 patients with traumatic complete sternoclavicular dislocations. Twelve patients were followed and their cases are discussed. Treatment may be closed or open. In some cases we did not attempt reduction because it may be very difficult to maintain and dislocation may recur. Open reduction is extremely difficult and not recommended unless a serious intrathoracic problem also exists. Based on our cases, we conclude that stability of the sternoclavicular joint is not necessary to ensure normal function of the involved limb. The residual prominence of the medial portion of the clavicle does not cause pain and does not interfere with chest or shoulder function.

Adolescent↗

PubMed1989

Computed tomographic appearances of sternocostoclavicular hyperostosis.

Computed tomographical analysis of sternocostoclavicular hyperostosis was performed in 27 patients. In the earliest stage hyperostosis occurred around the cartilaginous portion of the first ribs. The sternoclavicular joint space was preserved even in the late stage III of the disorder. These findings suggest that sternocostoclavicular hyperostosis develops around the costal cartilage including periosteum, perichondrium, and the ligamentous structures, and that the sternoclavicular joint is not primarily involved. It is also suggested that perichondritis and periostitis play important roles in the etiology of this disorder.

Adult↗

PubMed1979

Electromyographic study of the subclavius muscle.

The electromyographic study of the subclavius muscle (SM) was performed in 31 different movements, in 12 subjects (10 male and 2 female) aged from 17 to 28 years. The action potentials were obtained with an electromyograph Teca TE 4. Our findings suggest that the SM acts mainly on the stability of the sternoclavicular joint; with more or less intensity according to the degree of the clavicular interaction with the movements of the peripheral parts of the superior limb. The SM seems to act as a substitute for the ligaments of the sternoclavicular joint.

Adolescent↗

PubMedDate not supplied

[Shoulder girdle and shoulder joint tuberculosis].

From 1955 to 1980 inclusive, 50 patients with tuberculous omarthritis and 11 with specific shoulder girdle disorders (nine sternoclavicular joints, one isolated clavicular shaft focus, as well as one acromioclavicular joint focus) were treated at this clinic with a combined tuberculostatic and surgical therapy. The youngest patient was nine years old, and the oldest patient was 89 years old (36 females, 25 males). The patients (average age 49.4 years) comprised 11 foreign workers. From the beginning of the symptoms up to diagnosis, an average of 1.4 years elapsed. 34 patients (56%) had already been treated earlier for tuberculosis, and 12 (20%) were suffering at the same time from an active specific infection of other localisation. Independently of abscesses and fistulae (35 patients = 57%) as well as other simultaneous tuberculosis, the one-hour value of the erythrocyte sedimentation rate was in the normal range, or it was only marginally to slightly raised (under 20 mm according to W.). In 28 patients (46%), arthrodeses were performed in the shoulder joint, whereas the focus was cleared in the remaining patients. One patient (89 years old) died of senile debility. All complications (16 reactivations, two dislocations of the bone chip implantations, one fail joint) healed without complications after secondary operations. In the follow-up examination (on average, after 3.1 years), we diagnosed one recurrence (sternoclavicular joint process). Of the 45 patients (74%) followed up, 36 (80%) had started working again on average 12 months after the end of hospital treatment, or had resumed their former occupation (pensioners, housewives). Three (7%) of those followed up needed a different occupation or were given a new job within their firm.

Acromioclavicular Joint↗

PubMed2004

Pseudomonas sternoclavicular pyarthrosis.

Most cases of Pseudomonas pyarthrosis affecting the sternoclavicular joint have been reported in immunosuppressed intravenous drug users. We report a case of Pseudomonas pyarthrosis in a man who was otherwise immunocompetent, except for his age. A 66-year-old white man presented to the clinic with a 1-month history of right-sided shoulder and arm pain associated with swelling of the upper part of the chest in the region of the right sternoclavicular joint. The chest radiograph revealed opacity in the right superior mediastinum. Computed tomography scan of the chest confirmed a mass in the right sternoclavicular region with associated osteolysis of the clavicular head. A needle biopsy of the mass was negative for malignancy. An open biopsy specimen showed evidence of chronic inflammation without evidence of malignancy, and culture of the tissue grew Pseudomonas aeruginosa. The patient's symptoms improved after extensive incision and drainage of the affected area followed by treatment with antibiotics for 6 weeks.

Acute Disease↗

PubMed1979

[Suprasternal bone (author's transl)].

Human skeletons have many variations which may occasionally necessitate distinction from pathologic changes. Suprasternal bone is an unfamiliar normal variation in the vicinity of the sternoclavicular joint. It was first described by Béclard in 1820 and thereafter many reports have appeared, mostly in anatomy and embryology. An incidence less than 5% is reported abroad. This report describes the incidence of suprasternal bone in Japanese and a few clinical reference cases. Suprasternal bone is now considered to have derived from the persistent rudiment of epicoracoid which should have normally consisted of the part of manubrium sterni. Suprasternal tubercle is considered to be the osseously fused type of suprasternal bone. The material consisted of two groups: 1) Seventy-four sterna were examined roentgenographically which were removed en bloc from the cadavera. 2) 562 sterna of living subjects were examined roentgenographically by Kattan's method. In the seventy-four cadavera, eight cases had suprasternal bones (10.8%) and fourteen cases had suprasternal tubercles. Among them, three had suprasternal bone and tubercle on each side. In the 562 living subjects, thirty-nine cases had suprasternal bones (6.9%) and eight cases had suprasternal tubercles. Among them, three had both on each side. The incidence of suprasternal bone in Japanese is therefore higher than foreigners' reported previously. Kattan's method employed in this study is simple and excellent to show manubrium sterni and sternoclavicular joint clearly. It is emphasized that suprasternal bone is not uncommon and differential diagnosis from pathologic changes is easy as long as it is kept in mind.

Adult↗

PubMed2003

Degenerative sternoclavicular arthritis and hyperostosis.

Symptomatic arthritic involvement of the sternoclavicular joint is relatively uncommon and can be a result of distant trauma, infection, and sternocostoclavicular hyperostosis, post-menopausal arthritis, condensing osteitis of the proximal clavicle, or secondary to an underlying arthropathy. Patients with degenerative osteoarthritis due to trauma most commonly have had either an anterior or posterior dislocation, subluxation, or periarticular fracture. Medical claviculectomy with or without ligamentous stabilization is indicated only in situations of painful primary and secondary rheumatoid arthritis, or in patients with neoplastic lesions. Numerous authors have recommended surgical reconstruction but few have reported series larger than two or three cases. This article reviews a few specific arthropathy conditions about the sternoclavicular joint and discusses their nonoperative and operative management.

Adult↗

PubMed2004

Sternoclavicular septic arthritis: review of 180 cases.

We review 170 previously reported cases of sternoclavicular septic arthritis, and report 10 new cases. The mean age of patients was 45 years; 73% were male. Patients presented with chest pain (78%) and shoulder pain (24%) after a median duration of symptoms of 14 days. Only 65% were febrile. Bacteremia was present in 62%. Common risk factors included intravenous drug use (21%), distant site of infection (15%), diabetes mellitus (13%), trauma (12%), and infected central venous line (9%). No risk factor was found in 23%. Serious complications such as osteomyelitis (55%), chest wall abscess or phlegmon (25%), and mediastinitis (13%) were common. Staphylococcus aureus was responsible for 49% of cases, and is now the major cause of sternoclavicular septic arthritis in intravenous drug users. Pseudomonas aeruginosa infection in injection drug users declined dramatically with the end of an epidemic of pentazocine abuse in the 1980s. Sternoclavicular septic arthritis accounts for 1% of septic arthritis in the general population, but 17% in intravenous drug users, for unclear reasons. Bacteria may enter the sternoclavicular joint from the adjacent valves of the subclavian vein after injection of contaminated drugs into the upper extremity, or the joint may become infected after attempted drug injection between the heads of the sternocleidomastoid muscle. Computed tomography or magnetic resonance imaging should be obtained routinely to assess for the presence of chest wall phlegmon, retrosternal abscess, or mediastinitis. If present, en-bloc resection of the sternoclavicular joint is indicated, possibly with ipsilateral pectoralis major muscle flap. Empiric antibiotic therapy may need to cover methicillin-resistant Staphylococcus aureus (MRSA).

Adolescent↗