Sternoclavicular joint traumatic dislocation

Case contributed by Dr Bruno Di Muzio

Presentation

High-speed MVA.

Patient Data

Age: 17-year-old
X-ray

Chest AP radiograph

The heart size is normal for the projection. Extensive opacity throughout the left upper lobe is in keeping with pulmonary contusion in this clinical scenario. No evidence of displaced rib fractures. 

CT

CTA Chest (selected images)

Posterior left sternoclavicular joint dislocation with the proximal segment of the left clavicle compressing the left brachiocephalic vein. There is an associated anterior mediastinum haematoma, but no definitive features of active bleeding. Thoracic aorta has normal calibre and opacification, with no acute abnormalities. The remainder of the mediastinal structures are unremarkable. Patchy confluent airspace consolidations and groundglass opacities in the left upper lobe and in the medial aspects of the right lung. A tiny pneumothorax is identified adjacent ot the superior segment of the right lower lobe. Lungs and pleural spaces are otherwise unremarkable. Non-displaced fracture through the lateral margin of the right scapula.

Case Discussion

Sternoclavicular joint dislocation is rare and usually related to blunt trauma. Retrosternal/posterior dislocation is a serious lesion as it can cause compression of vital structures such as the trachea, great vessels, and nerves. Fortunately, no major vascular lesions or tracheal lesions were identified in this patient. 

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Case information

rID: 48115
Case created: 19th Sep 2016
Last edited: 28th Oct 2016
System: Chest
Tag: rmh
Inclusion in quiz mode: Included

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