Presentation
Fall from a height. Right clavicle and shoulder pain.
Patient Data
Medial ends of the clavicles are at incongruent heights, with the painful right clavicle inferior to the left clavicle, suggesting posterior dislocation of the right sternoclavicular joint.
On frontal projection, the humeral head has a lightbulb appearance. This is due to internal rotation of the shoulder caused by a sling-harness (rather than a posterior dislocation), and congruency of the glenoid and humerus can be confirmed on both frontal and lateral views.
CT confirms posterior dislocation of the right sternoclavicular joint, with the medial head of the right clavicle compressing the junction of the right and left brachiocephalic veins.
Case Discussion
Posterior dislocations of the sternoclavicular joints are often the result of high impact trauma and it can be important to assess the underlying vessels with CT for injury.
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