Sternoclavicular joint dislocation

Case contributed by Yasser Asiri
Diagnosis almost certain

Presentation

History of trauma

Patient Data

Age: 16 years
Gender: Male

Widening and asymmetry of the right sternoclavicular joint with abnormal position of the distal clavicle in relation to the manubrium. This is in keeping with a sternoclavicular joint dislocation.

CT confirmed the dislocation of the right sternoclavicular joint with the medial end of the clavicle being posteriorly displaced and causing mild mass effect on the right brachiocephalic vein. Surrounding fat stranding, small bony fragment and high density fluid is seen around the joint.

Case Discussion

Sternoclavicular joint dislocation is seen when there is abnormal relationship between the medial end of the clavicle and the clavicular notch of the manubrium. It is classified according to the direction of the displaced medial clavicle into anterior or posterior types.

The anterior dislocation type is far more common than the posterior dislocation type. Posterior dislocation can be life threatening due to risk of injuring the superior mediastinal structures; therefore, CT study is usually performed to assess the direction of the dislocation and to rule out any associated injuries. IV contrast can be administered for better assessment of the vessels in particular.

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