Sternoclavicular joint dislocation

Sternoclavicular joint (SCJ) dislocation is rare, accounting for only ~2% of joint dislocations and especially when compared to other traumatic upper limb injuries such as clavicular fractures

Most cases result from indirect trauma 5, especially high-speed motor vehicle accidents. Spontaneous dislocations can also occur, these are typically anterior and occur in young men 2

The injury can be broadly categorised into two types:

  • anterior: two-to-three times more common, less serious
  • posterior: potentially more serious because of the possibility of damage to mediastinal structures (e.g. great vessels, trachea, oesophagus, etc.) as a result of posterior displacement of the medial clavicle head. These injuries should prompt assessment of the mediastinal structures with CTA
  • bilateral: easily missed on plain film imaging, a rare however necessary consideration, best demonstrated on crossectional imaging 7

SCJ dislocations are associated with the following injuries 3:

  • joint space widening at the sternoclavicular joint
  • more easily visualised on an angled view, on this view inferior displacement of the medial head of the clavicle is indicative of a posterior dislocation, whereas superior displacement of the clavicle indicates an anterior dislocation 6
  • difficult to determine anterior or posterior dislocation 

Options include conservative treatment, especially for anterior dislocation. Posterior dislocations are normally treated with closed reduction. Surgical fixation (ORIF) is usually reserved for unreduced posterior dislocations 2

Thoracic outlet syndrome may occur as a late complication of posterior dislocation.

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Article information

rID: 6858
Synonyms or Alternate Spellings:
  • Sternoclavicular joint (SJC) dislocations

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Cases and figures

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    Case 2
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     Case 3: posterior dislocation
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    Case 4: posterior
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    Case 5
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