Overview
what it is and why it mattersThe sternoclavicular (SC) joint is the small joint at the front of your chest where the inner end of your collarbone meets your breastbone. Injuries to this joint range from mild sprains (the most common kind) to full dislocations. Anterior dislocations — where the collarbone pops forward — are the less dangerous version. Posterior dislocations — where it pops backward, toward the chest — are an emergency: the dislodged collarbone can press on the windpipe, swallowing tube, or major blood vessels sitting right behind it. SC dislocations are uncommon and usually take a serious impact — a hard hit in football or a high-speed car wreck.
Symptoms
what you may notice- Pain at the front of the chest where the inner collarbone meets the breastbone, worse with arm movement
- Swelling and tenderness right over the joint
- A visible bump (anterior dislocation) or a sunken spot (posterior dislocation) at the inner end of the collarbone
- Pain when reaching across the body or lifting the arm overhead
- Difficulty breathing, trouble swallowing, or a feeling of choking — red flags for a posterior dislocation pressing on airway structures
- Pain with deep breathing, coughing, or any motion that shifts the shoulder girdle
Diagnosis
exam first, imaging secondPain, swelling, and a visible bump (or sunken spot) at the inner end of the collarbone. Standard X-rays of this joint are notoriously hard to read — the bony overlap of the chest hides the joint. A CT scan is the definitive test when a dislocation is suspected. For a posterior dislocation, we coordinate with a chest surgeon because of the risk to the structures sitting just behind the joint.
Treatment Path
how care progresses at OSI1
Sling and symptomatic care
Sprains and most anterior (forward) dislocations are managed without surgery: a sling for comfort and gradual return to activity as the pain settles.
2
Closed reduction
For an acute dislocation, your provider can sometimes pop the joint back into place under sedation. For a posterior dislocation, that maneuver is done in the operating room with a chest surgeon standing by — because if the joint reduction doesn't go cleanly, the structures behind it need immediate attention.
Surgical Options at OSI
if non-operative care isn't enoughPosterior dislocations that are pressing on the airway, swallowing tube, or blood vessels are surgical emergencies. Chronic instability — where the joint keeps slipping out and causing pain after the initial injury — is addressed with a reconstruction that uses a tendon graft to rebuild the supporting ligaments.
Providers Who Treat Sternoclavicular Injury
sports-medicine team
Further Reading
authoritative sourcesExternal patient-education references and related OSI pages for additional background: