Updated: 6/3/2021

Sternoclavicular Joint

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https://upload.orthobullets.com/topic/3034/images/serendipity view2.jpg
https://upload.orthobullets.com/topic/3034/images/ct scan.jpg
https://upload.orthobullets.com/topic/3034/images/sternoclavicular joint.jpg
https://upload.orthobullets.com/topic/3034/images/serendipity view.jpg
  • Introduction
    • Diarthrodial saddle joint incongruous (~50% contact)
      • fibrocartilage (not synovial cartilage)
      • contains an intra-articular disc
    • Motion
      • elevation of arm to 90° leads to rotation of the sternoclavicular joint of 30°
    • Imaging
      • best assessed radiographically by Serendipity view
        • involves 40° cephalic tilt view of sternum and clavicle
        • CT scan is most sensitive and specific
  • Stabilizing Ligaments of Sternoclavicular Joint
    • Posterior sternoclavicular capsular ligament
      • primary restraint for anterior-posterior stability
    • Anterior sternoclavicular ligament
      • primary restraint to superior displacement of medial clavicle
    • Costoclavicular (rhomboid) ligament
      • anterior fasciculus resists superior rotation and lateral displacement
      • posterior fasciculus resists inferior rotation and medial displacement
    • Intra-articular disk ligament
      • prevents medial displacement of clavicle
      • secondary restraint to superior clavicle displacement
  • Medial Clavicle Anatomy
    • Clavicle is the first bone to begin the ossification process
      • ossifies between 5th and 6th weeks of gestation
    • Clavicle is the last bone to complete the ossification process
      • medial epiphysis of clavicle is last physis to close at 20-25 yrs
    • Important to distinguish SC dislocations from physeal fractures
      • most injuries at this location involve the medial clavicular physis before age of 25
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