Sternoclavicular Joint (SC joint)

What is the Sternoclavicular Joint (SC joint)?

The sternoclavicular joint is the joint between the breastbone (sternum) and the collar bone (clavicle). The SC joint is one of the 4 joints that complete the shoulder and is the only joint that links the arm to the body. Like any other joints, the SC joint is covered by articular cartilage that helps the bones slide effortlessly against each other during arm and shoulder movement. Tough connective tissue known as ligaments surrounds the SC joint providing stability and strength.

Causes of Sternoclavicular Joint Disorders

Injuries to the SC joint are called sternoclavicular joint injuries and can include stretching or tearing of the ligaments. It is usually caused due to severe trauma or a direct blow to the side of your body such as in motor vehicle accidents or contact sports like football or rugby.

Disorders of the Sternoclavicular Joint

The sternoclavicular joint is susceptible to the same disease processes as other synovial joints, including:

• Infection
• Instability from injury
• Rheumatoid disease
• Osteoarthritis
• Injuries ranging from a sprain to a fracture
• Joint dislocations

Symptoms of Sternoclavicular Joint Disorders

Typically, symptoms of sternoclavicular joint disorders include:

• Tenderness, bruising or swelling over the joint
• Limited range of motion in the arm
• Grinding or crunching sound on arm movement
• Chills, fever, or night sweats along with redness over the joint due to infection
• Simultaneous radiation of pain to other joints due to an inflammatory condition

Diagnosis of Sternoclavicular Joint Disorders

Medical history, physical examination, and analysing your symptoms are sufficient to diagnose the condition. However, your doctor may recommend imaging tests such as X-rays, MRI, and CT scans to confirm the diagnosis.

Treatment for Sternoclavicular Joint Disorders

Treatment for sternoclavicular joint disorders may be surgical or non-surgical and most cases of SC joint disorders can be treated non-surgically.

Non-Surgical Treatment

• Medications: NSAIDs or non-steroidal anti-inflammatory drugs like naproxen and ibuprofen can be used to bring down swelling and pain in the SC joint.
• Immobilisation: A shoulder sling can be used to restrict arm movement during an injury or fracture and allow healing.
• Activity Modification: Avoiding activities that induce painful symptoms is recommended for patients with SC joint osteoarthritis.
• Injections: Corticosteroid injections to the joint are recommended for patients with an inflammatory condition or osteoarthritis to provide relief from pain and swelling.
• Closed Reduction: This is a procedure where your doctor will manipulate the clavicle back into place without making a cut in the skin when you have a joint dislocation.

Surgical treatment is performed only if non-surgical treatments fail and include:

ORIF (open reduction and internal fixation): During this procedure, your surgeon will reposition the pieces of the fractured bone surgically so that the bones are back in their proper alignment and then secure the fragments of the bones to each other by using metal plates, screws, wires, or pins.

Other procedures: An SC joint infection requires an urgent operation wherein the joint is opened up and the infection is drained out followed by a course of antibiotics.

For severe osteoarthritis of the SC joint, your doctor may recommend removing bone from the arthritic and painful end of the clavicle to allow more room for movement.