Pediatric Sternoclavicular Joint Dislocation

  • Etiology: Blunt thoracic trauma
  • Imaging Radiograph:
    — Joint space widening
    — Can be anterior or posterior and posterior is difficult to see on radiograph
  • Imaging CT:
    — Perform with IV contrast looking for vascular injury and patency of subclavian artery
    — Joint space widening
    — Can be anterior or posterior
  • DDX:
  • Complications: Posterior dislocation associated with injury to great vessels and trachea and esophagus
  • Treatment: Surgical reduction
  • Clinical:

Radiology Cases of Sternoclavicular Joint Dislocation

Radiology Cases of Posterior Sternoclavicular Joint Dislocation

CT of sternoclavicular joint dislocation
3D CT without contrast of the chest viewed anteriorly (above) shows normal alignment of the left sternoclavicular joint and malalignment of the right sternoclavicular joint. 3D CT viewed from above (below) shows the right clavicular head is displaced posteriorly to the manubrium of the sternum when compared to the left clavicular head.
3D CT of posterior sternoclavicular joint dislocation
CT 3D reconstruction without contrast of the sternoclavicular joints viewed from anteriorly (above) and from underneath (below) shows widening of the right sternoclavicular joint space when compared to the left sternoclavicular joint space. The right clavicular head is also displaced posteriorly when compared to the left sternoclavicular head.
CT of sternoclavicular joint dislocation
CXR AP shows a widened superior mediastinum. Axial CT with contrast of the chest shows a mediastinal hematoma and a right sternoclavicular joint disruption that was displaced posteriorly. Angiogram was negative for aortic injury. Venogram was negative for large vessel venous injury.