Sternoclavicular joint dislocation

Dr Henry Knipe and Dr Jeremy Jones et al.

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 categorized into two types:

  • anterior
    • two-to-three times more common
    • less serious
  • posterior
    • often occult clinically
    • can be occult or subtle on radiographs
    • potentially more serious because of the possibility of damage to mediastinal structures (e.g. great vessels, trachea, esophagus, etc.) as a result of posterior displacement of the medial clavicle head.
    • these injuries should prompt assessment of the mediastinal structures with CTA

Bilateral dislocations are easily missed on plain film imaging, a rare however necessary consideration, best demonstrated on cross sectional imaging 7

SCJ dislocations are associated with the following injuries 3:

  • joint space widening at the sternoclavicular joint
  • more easily visualized 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.

Share article

Article information

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

Support Radiopaedia and see fewer ads

Cases and figures

  • Case 1
    Drag here to reorder.
  • Case 2
    Drag here to reorder.
  •  Case 3: posterior dislocation
    Drag here to reorder.
  • Case 4: posterior
    Drag here to reorder.
  • Case 5
    Drag here to reorder.
  • Updating… Please wait.

     Unable to process the form. Check for errors and try again.

     Thank you for updating your details.