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Sternoclavicular Joint

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Description

The sternoclavicular joint[1]
Ligaments of the sternoclavicular joint[2]
Anatomy of the sternoclavicular joints, viewed from the anterior aspect with the left joint intact and the right joint in coronal section[3]
The sternoclavicular joint is seen on this axial CT with intra-articular gas outlining the intra-articular disc[4]

Name

  • Sternoclavicular Joint
  • SC Joint
  • Sternoclavicular articulation

General

  • Joint created by articulation of Sternum and Clavicle
  • Diarthrodial, saddle-type synovial joint
  • Inherently unstable due to poor osseus articulation
  • Less than 50% of the medial clavicle articulates with the corresponding manubrium
  • Contributes to the shoulder girdle

Ligaments

Fibrocartilagenous disc

  • Attached to the anterior and posterior SC ligaments and capsule
  • Divides SJC into two synovium-lined cavities
  • Degenerates over time and by age 70-80 is incomplete[6]

Subclavius Muscle

  • Arises from the first rib just lateral to the costoclavicular ligament and inserts onto the inferior surface of the clavicle.
  • It is believed to have a protective function with regards to the stability of the SCJ by reducing the rate of upward displacement of the clavicle when it is under lateral compressive loads

Additional

  • From intrinsic and extrinsic ligamentous structures[7]
  • Only bony articulation between axial skeleton, upper extremity[8]
  • Clavicle is first bone to ossify in utero, last to fuse occuring between ages 23-25[9] This can make distinguishing physeal injuries from sternoclavicular dislocations challenging.

Biomechanics

  • All shoulder girdle movement results in some degree of movement at the SCJ
  • Every 10° of shoulder flexion results in 4° elevation of the clavicle[10]
  • Shoulder retraction: SCJ translates anteriorly
  • Shoulder protraction: SCJ translates posteriorly
  • Subsequently, clavicle can rotate up to 40° in long axis

Clinical Significance

See Also

  1. ↑ Image courtesy of orthobullets.com, "Sternoclavicular Join"
  2. ↑ Groh, Gordon I. "Sternoclavicular Joint Injuries." Clavicle Injuries: A Case-Based Guide to Diagnosis and Treatment. Cham: Springer International Publishing, 2017. 145-163.
  3. ↑ Smith, J. E., J. Kennedy, and M. Brinsden. "Sternoclavicular joint injuries." Trauma 12.2 (2010): 117-122.
  4. ↑ Case courtesy of Craig Hacking, Radiopaedia.org, rID: 48873
  5. ↑ Spencer EE, Kuhn JE, Huston LJ, Carpenter JE, Hughes RE. Ligamentous restraints to anterior and posterior translation of the sternoclavicular joint. J Shoulder Elbow Surg. 2002;11:43–47.
  6. ↑ van Tongel A, MacDonald P, Leiter J, Pouliart N, Peeler J. A cadaveric study of the structural anatomy of the sternoclavicular joint. Clin Anat. 2012;25:903–910.
  7. ↑ Sewell MD, Al-Hadithy N, Le Leu A, Lambert SM. Instability of the sternoclavicular joint: current concepts in classification, treatment and outcomes. Bone Joint J. 2013;95-B:721–731.
  8. ↑ Spencer EE, Kuhn JE, Huston LJ, Carpenter JE, Hughes RE. Ligamentous restraints to anterior and posterior translation of the sternoclavicular joint. J Shoulder Elbow Surg. 2002;11:43–47.
  9. ↑ Wirth MA, Rockwood CA. Acute and Chronic Traumatic Injuries of the Sternoclavicular Joint. J Am Acad Orthop Surg. 1996;4:268–278.
  10. ↑ Inman VT, Saunders JB, Abbott LC. Observations of the function of the shoulder joint. 1944. Clin Orthop Relat Res. 1996;(330):3–12.
Created by:
John Kiel on 2 January 2020 15:49:47
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Last edited:
9 April 2025 19:14:18
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