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PubMed1995

[Swelling of the sternoclavicular joint].

From 1990 through 1993 nine patients presented with unexplained swelling of the sternoclavicular joint. In some cases a tumor was suspected. The clinical histories included trauma with injury of forearm and wrist or strain on the shoulder girdle without acute onset of any symptoms in the sternoclavicular joint. In trauma cases the time from injury to onset of symptoms was between 1 day and 1 year (median 5 weeks). CT studies demonstrated widening of the joint space in two cases, thickening of the pectoral muscle in six cases and thickening of capsule and ligaments in five cases. In one case arthroplasty of the sternoclavicular joint was performed and in a second we performed a biopsy. The remaining cases were not treated. Other differential diagnoses to be considered in the case of a swelling of the sternoclavicular joint are listed.

Adolescent↗
PubMed2004

Posterior sternoclavicular joint dislocation in a wrestler.

Injury to the sternoclavicular joint is uncommon but may be a life-threatening injury if the diagnosis is not made acutely. Posterior sternoclavicular joint dislocation is associated with a number of complications including tracheal tear or trauma to the great vessels. Diagnosis by conventional radiography is difficult. Even experienced examiners may miss the diagnosis unless a high level of suspicion exists and the appropriate imaging studies are ordered. Computed tomography is the imaging modality of choice, and prompt diagnosis is essential for early, successful reduction of the joint.

Adolescent↗
PubMed1988

High resolution computed tomography of the cadaveric sternoclavicular joint: findings in degenerative joint disease.

High resolution, narrow collimation, axial computed tomography of the sternoclavicular joint was used to describe changes secondary to degenerative joint disease in 32 cadaveric specimens. The distribution and pattern of sclerosis, cystic changes, and osteophyte formation in the axial plane were well demonstrated using this technique. Joint space narrowing was sometimes difficult to assess. Subtle joint space calcification was exquisitely demonstrated using computed tomography. Clavicular head cupping, an anatomic variant, may predispose to more severe degenerative change. Computed tomography is an excellent means to analyze the sternoclavicular joint for the presence of degenerative joint disease and may be the imaging modality of choice in assessing articular disorders of the sternoclavicular joint.

Adolescent↗
PubMed2000

Dislocations of the sternoclavicular joint.

The effects of the anterior and posterior sternoclavicular joint (SCJ) soft tissue structures on joint dislocation strength by sequential sectioning the ligaments and capsule of twenty-eight SCJs were evaluated. The medial clavicle of each specimen was initially loaded in the anterior and posterior directions to provide control values for joint laxity. The anterior or posterior ligaments and capsular structures of the SCJs were then selectively cut and the specimens retested for laxity and then loaded to failure simulating either anterior or posterior dislocation. Testing of intact specimens showed that the posterior ligaments were stiffer than other structures in that it was significantly more difficult to posteriorly displace the SCJ than in any other direction and that the capsule was the important anterior structure affecting joint laxity. Load-to-failure testing showed that it required 50% more force to create a failure by posterior dislocation than by anterior dislocation. The results of this study explain the clinical rarity of posterior sternoclavicular joint dislocations.

Aged↗
PubMed1978

Sternoclavicular joint involvement in ankylosing spondylitis.

Two patients with sternoclavicular joint involvement in ankylosing spondylitis are described, both of whom presented with referred pain syndromes which delayed diagnosis. The anatomy of the sternoclavicular joint and the salient features of this entity are reviewed.

Adult↗
PubMed1990

Sternoclavicular joint infection in hemodialysis patients.

Infection of the sternoclavicular joint due to Staphylococcus aureus occurred in 2 hemodialysis patients. Good results were achieved in both cases by applying appropriate antibiotic therapy. Sternoclavicular joint sepsis is rare. However, it is often associated with underlying conditions, and hemodialysis must be recalled as one of the possible predisposing factors.

Arthritis, Infectious↗
PubMed1994

Bilateral sternoclavicular joint septic arthritis presenting as cutaneous abscesses.

The sternoclavicular joint can be involved in ankylosing spondylitis as well as in rheumatoid and degenerative arthritis. Septic arthritis of this joint is infrequently seen, and the diagnosis of this infection can be missed until it presents with a complication. We describe a patient with bacteremia whose presentation of bilateral sternoclavicular joint septic arthritis was multiple cutaneous abscesses on her chest wall.

Abscess↗
PubMed2001

Clinical features of septic arthritis of sternoclavicular joint.

We studied 21 patients with septic arthritis of the sternoclavicular joint at Chulalongkorn University Hospital between January 1987 and January 1997. There were 15 males (71.4%) and 6 females (28.6%). The mean age was 47.4 years with a range of 16 to 69. More than half of the patients (57.1%) were aged more than 50 years and most had associated diseases including diabetes mellitus and cirrhosis. Almost all of the younger age group had a history of intravenous drug abuse. All of the patients had fever and sternoclavicular joint pain. Most of the patients (66.7%) had monoarticular arthritis, whereas, the others had oligoarticular arthritis. Staphylococcus aureus was the most commonly or identified organism in the patients. Retrosternal abscess was seen by computerized tomography in 6 patients (28.6%). All patients received parenteral antibiotics, and 5 patients (23.8%) required surgical drainage of a retrosternal abscess. Eighteen patients recovered but there were 3 (14.3%) deaths. All of these had retrosternal abscesses. The major cause of death was septic shock. Septic arthritis of the sternoclavicular joint is an uncommon disease in Thai clinical practice. Although uncommon, retrosternal abscess is a life threatening complication.

Acromioclavicular Joint↗
PubMedDate not supplied

Ligamentous restraints to anterior and posterior translation of the sternoclavicular joint.

This experiment was conducted to determine the primary ligamentous restraints to anterior and posterior translation of the sternoclavicular joint. Twenty-four unpaired cadaver specimens were mounted in a custom fixture. Anterior and posterior translations were measured under a sub-failure load in the intact specimen and again after transecting one randomly chosen ligament (anterior capsule, posterior capsule, interclavicular ligament, and costoclavicular ligament; n = 6 for each group). Cutting the posterior capsule resulted in significant increases in anterior translation and posterior translation. Cutting the anterior capsule produced significant increases in anterior translation. Cutting the costoclavicular and interclavicular ligaments had little effect on sternoclavicular joint translation. The posterior capsule is the most important restraint for anterior and posterior translation of the sternoclavicular joint. The anterior capsule is another important restraint for anterior translation. The costoclavicular and interclavicular ligaments have little effect on anterior or posterior translation of the sternoclavicular joint.

Aged↗
PubMed2005

Posterior sternoclavicular joint dislocation in children-role of spiral computed tomography.

Traumatic posterior dislocation of the sternoclavicular joint is an uncommon injury in children. It is not normally well seen on plain films. We report 2 cases where spiral computed tomography with intravenous contrast confirmed the clinical suspicion of sternoclavicular joint dislocation and also allowed assessment of the adjacent mediastinum for possible complications. Emergency physicians should be aware that the use of spiral computed tomography is the procedure of choice in posterior sternoclavicular joint dislocation. This is particularly helpful in allowing multiplanar reconstruction to show complications arising in the mediastinum.

Adolescent↗
PubMed2003

Posterior sternoclavicular joint dislocation: the value of intra-operative ultrasound.

The sternoclavicular joint dislocates posteriorly if the costoclavicular ligaments, posterior capsule, and anterior capsule have all been disrupted. Diagnosis of a posteriorly dislocated sternoclavicular joint is difficult on clinical examination and with plain X-rays. The treatment objective is to obtain a closed reduction, and failing this an open reduction is indicated. In the intra-operative setting the evaluation of the reduction when performed through closed means can be somewhat difficult, and intra-operative plain films do not give clear answers. Ultrasound as an imaging modality for these injuries was shown to demonstrate the state of the joint in terms of reduction, more clearly than X-rays (P<0.001). It was accurately interpreted by the vast majority of orthopaedic surgeons in an investigation, and is of great value in the intra-operative setting to confirm whether a closed reduction has been successful or not. A case is reported illustrating its use.

Adult↗
PubMed1991

Dislocations of the sternoclavicular joint: anatomic basis, etiologies, and radiologic diagnosis.

Dislocations of the sternoclavicular joint are relatively uncommon, but diagnosis and management can be difficult, with posterior dislocations being potentially very serious. The anatomy of the joint, and the mechanisms of dislocation, are described. The radiologic diagnosis is discussed and three case reports are presented to illustrate varieties of dislocation. Although computed tomography is the ideal method of demonstrating the sternoclavicular joint, some specialized plain film projections are often useful. These should be more widely known and are described and illustrated. Treatment is briefly discussed.

Adolescent↗
PubMed1976

Sternoclavicular joint enlargement following block dissection.

The sternoclavicular joint may become enlarged subsequent to block dissection of the neck. It should be managed conservatively and does not require removal, although both clinical and X-ray appearances may give rise to suspicion of metastasis in the head of the clavicle. A hypothesis of the pathology of this unfamiliar condition is proposed.

Female↗
PubMed2005

Spontaneous sternoclavicular joint infection.

Spontaneous infection of the sternoclavicular joint (SCJ) is an uncommon clinical entity. There are only few reports about this entity in the literature. Various risk factors are found to be associated with SCJ infection but rarely no risk factors can be detected. As a result of its rarity and confusing with malignancies, the description of this condition is primarily in the form of case reports and small series in the literature. Besides, optimal therapy has not been described definitely. We present a case of spontaneous SCJ infection treated successfully by drainage and the use of nonsteroidal antiinflammatory drug.

Aged↗
PubMed2006

[Myositis of the sternocleidomastoid muscle as a result of arthritis of the sternoclavicular joint].

This article describes a rare case of a myositis of the sternocleidomastoid muscle due to an acute septic arthritis of the sternoclavicular joint. A 51-year-old male in reduced condition was admitted to the Department of Otorhinolaryngology with a one-week history of a painless swelling of the sternocleidomastoid muscle associated with recurrent fever. Physical examination was otherwise unremarkable. An intravenous antibiotic therapy was initiated without improvement of the process, accordingly a specific infection or a malignancy was ruled out by biopsy. The positron emission tomography and magnetic resonance imaging finally revealed the diagnosis of a septic arthritis of the sternoclavicular joint as the causal focus of the infection. After an extensive surgical debridement and under continued antibiotic therapy the patient made an uneventful recovery. The acute septic arthritis of the sternoclavicular joint is an uncommon infection with an insidious onset and is often unrecognized until it spreads to adjacent structures leading to serious complications. This case emphasizes that a myositis of sternocleidomastoid muscle can be caused by an ascending infection due to an acute septic arthritis of the sternoclavicular joint. Clinical course, diagnosis and treatment of this uncommon disease are reviewed in this article.

Acute Disease↗
PubMed1997

Resection arthroplasty of the sternoclavicular joint.

The results of resection of the medial end of the clavicle to treat a painful sternoclavicular joint in fifteen patients were retrospectively reviewed. The patients fell into two groups: eight patients who had had a primary arthroplasty of the sternoclavicular joint in which the costoclavicular ligament was left intact (group I), and seven patients who had had revision of a failed arthroplasty of the sternoclavicular joint and in whom the costoclavicular ligament had to be reconstructed (group II). The results for these two groups were compared at an average of 7.7 years postoperatively. All eight patients in group I had an excellent result. In sharp contrast, three patients in group II had an excellent result, three had a fair result, and one had a poor result. We conclude that preservation or reconstruction of the costoclavicular ligament is essential at the time of resection of the medial portion of the clavicle in order to obtain a satisfactory result.

Adolescent↗
PubMed2000

The sternoclavicular joint: variants of the discus articularis.

OBJECTIVE: To study the anatomy of the sternoclavicular joint, its discus and its variations.Design. Anatomical study (macroscopic dissection). BACKGROUND: Textbooks on manual therapy give different descriptions of the movements of this joint. These apparent contradictions could be due to poor understanding of the anatomy of this joint resulting in ignoring specific movement patterns under particular conditions. METHODS: Macroscopic dissection of 22 embalmed sternoclavicular joints. RESULTS: The sternoclavicular and the costoclavicular parts of the discus always were quite distinct in orientation, thickness, surface and consistency. The sternoclavicular part was attached to the dorso-cranial part of the extremitas sternalis claviculae by a broad insertion in which several small blood vessels are visible. This part is grossly vertical, thicker than the lateral part and has a fibrous aspect. The costoclavicular part of the discus is always thinner than the sternoclavicular part. Sometimes it is reduced to a fine translucent pellet or is perforated. Subsynovial vascular arcades run along the insertion of the discus on the joint capsule, both on sternal and on clavicular sides. The costosternal articular surface can be divided into a sternal and a costal segment, separated by a vascular zone. CONCLUSIONS: Findings suggest different functions of the distinct parts of the joint. The smooth aspect of the lateral segment of the costosternal articular surface and of the costoclavicular part of the discus could be an argument to consider a functionally distinct costoclavicular compartment. The insertion of the discus on the clavicula strongly suggests that small movements take place between clavicula and discus and that the discus itself is moved only when the increasing amplitude stretches this insertion. We hypothesise that all midrange movements take place between the convex inferior edge of the clavicula and the costoclavicular part of he discus and that larger elevation depression and pro- and retraction movement take place, respectively, between clavicula and discus or discus and sternum. In three specimens we observed a previously not described arterial ramus articularis originating from the left thyrocervical trunk.RelevanceThese findings might explain differences of the arthrokinematic behaviour of this joint between midrange and full range motions.

Dissection↗