Scheroclavicular joint dislocation causes symptoms treatment and diagnosis

Sternoclavicular joint dislocation is considered a rare injury that many people may not have heard of. However, it is actually a condition that deserves serious attention, especially because it occurs in a sensitive area that connects the collarbone (clavicle) to the breastbone (sternum) in the center of the chest.At first, it may simply appear as mild pain or slight swelling after an injury or fall, but in reality, the severity of this condition can vary widely. In some cases, it may develop into a serious problem if it is not managed properly and promptly.The danger of sternoclavicular joint dislocation lies in its close proximity to vital structures within the chest, such as the major blood vessels, the trachea, and the esophagus. This makes accurate diagnosis and rapid medical intervention essential to prevent possible complications.Therefore, in my Dalily Medical guide, understanding this injury—its causes, symptoms, and treatment methods—is an important step for anyone interested in musculoskeletal health and overall body safety.

Is sternoclavicular joint dislocation dangerous?

In most cases of anterior dislocation, the injury is not considered highly dangerous and can often be managed with conservative treatment.

However, in the case of posterior dislocation, the condition can be serious, as it may lead to compression of:

Major blood vessels
The trachea (windpipe)
The esophagus

For this reason, posterior dislocation is considered a medical emergency that requires prompt and careful intervention.

Does sternoclavicular joint dislocation always require surgery?

No, surgery is not always necessary.

In some cases, conservative treatment can be sufficient, which includes:

Joint reduction (realignment)
Immobilization
Physical therapy

However, surgery may be required in the following situations:

Posterior dislocation
Unstable dislocation
Chronic or recurrent cases

Can the joint return to its normal position on its own?

In some mild or partial cases, the condition may improve gradually over time without surgical intervention.

However, in complete dislocations, the joint usually does not return to its normal position spontaneously and requires medical treatment such as reduction, stabilization, or surgery depending on severity.

Does the pain last for a long time?

Pain is usually severe at the beginning of the injury, then gradually improves over a few weeks. However, mild pain or discomfort during shoulder movement may persist in some cases, especially if the injury is severe or if proper treatment and rehabilitation are not followed.

Does this injury affect arm movement?

Yes, it may temporarily affect arm movement due to pain and joint instability.

However, with proper treatment and adherence to physical therapy, shoulder function gradually improves, and most patients regain normal movement over time.

Types of sternoclavicular joint dislocation

Sternoclavicular joint dislocation (between the clavicle and sternum) can be classified based on severity and direction.

1) Based on severity

1. Partial dislocation (Subluxation)

The joint is partially displaced, not fully separated
Ligaments still hold part of the joint
Moderate pain
Limited shoulder movement
Less severe than complete dislocation

2. Complete dislocation

The clavicle fully separates from the sternum
Clear displacement of the joint
Severe pain with visible deformity
Often requires urgent medical care

2) Based on direction

1. Anterior dislocation (forward)

The clavicle moves forward
Most common type
Visible prominence at the upper chest
Generally less dangerous than posterior dislocation

2. Posterior dislocation (backward)

The clavicle moves backward toward the chest
Most dangerous type because it may compress:
- Major blood vessels
- Trachea
- Esophagus
May cause breathing or swallowing difficulties

3. Superior or inferior dislocation (rare)

Very uncommon
The clavicle moves upward or downward
Usually caused by severe trauma or high-impact injuries

Causes of sternoclavicular joint dislocation

1) Direct trauma (most common)

A strong blow to the shoulder or chest
Car accidents (especially seatbelt-related injuries)
Falling directly onto the shoulder or chest

2) Sports injuries

Contact sports such as:

Football
Wrestling
Rugby
Or injuries caused by falls or collisions during training

3) Indirect injuries

Strong lateral force on the shoulder
Sudden backward or forward movement of the shoulder

4) High-energy trauma

Motorcycle accidents
Falls from height
Severe workplace injuries

5) Ligament weakness (less common)

Joint hypermobility (loose ligaments)
Certain conditions that weaken ligaments
Previous injuries in the same joint

Symptoms of sternoclavicular joint dislocation

Symptoms vary depending on the type (anterior or posterior) and severity of the injury.

General symptoms

Severe pain in the upper chest or at the base of the neck
Swelling around the joint
Visible deformity or prominence of the clavicle
Difficulty moving the shoulder or lifting the arm
Feeling of shoulder instability or weakness

Anterior dislocation (most common)

Noticeable forward prominence of the clavicle
Pain that worsens with movement or pressure
Limited shoulder mobility
Mild swelling or bruising in some cases

Posterior dislocation (most dangerous)

This type is considered an emergency because it may compress vital structures inside the chest.

Symptoms include:

Severe chest pain or pain behind the sternum
Difficulty breathing or a feeling of choking
Difficulty swallowing
Less obvious swelling compared to anterior dislocation
Dizziness or palpitations in some cases due to vascular compression

Diagnosis of sternoclavicular joint dislocation

Diagnosis is very important because this injury may not be clearly visible on standard X-rays, especially in posterior dislocation cases.

1) Clinical examination

The doctor will:

Take a detailed medical history (accident, fall, trauma)
Examine the shoulder and upper chest
Look for:
- Visible deformity or depression at the joint
- Pain on palpation
- Limited arm movement
Compare both sides for asymmetry

2) X-ray imaging

Usually the first imaging step
Often not clear enough for this joint
May appear normal even if injury exists
Not reliable alone in many cases

3) CT scan (most important) ⭐

The most accurate diagnostic tool, showing:

Direction of dislocation (anterior or posterior)
Severity (partial or complete)
Compression of blood vessels or vital organs
Sometimes contrast is used for better vascular assessment

4) MRI scan

Not essential in acute cases
Useful for:
- Ligament evaluation
- Soft tissue and surrounding structure assessment

5) Special X-ray views

Such as the Serendipity view:

Helps visualize the clavicle more clearly
Used as an additional supportive tool

Medical (drug) treatment of sternoclavicular joint dislocation

Drug therapy is part of conservative treatment and aims to:

Relieve pain
Reduce inflammation and swelling
Improve temporary mobility

⚠️ Important: Medications do not reposition the joint; they only relieve symptoms.

1) Pain relievers

Mild analgesics

Paracetamol
Used for mild to moderate pain with limited anti-inflammatory effect

Non-steroidal anti-inflammatory drugs (NSAIDs)
Such as:

Ibuprofen
Diclofenac
Naproxen

Benefits:

Pain relief
Reduction of inflammation and swelling
Temporary improvement in movement

⚠️ Should be taken after food and not used long-term without medical advice

2) Muscle relaxants

Examples:

Tizanidine
Cyclobenzaprine

Benefits:

Reduce muscle spasm
Decrease pain related to muscle tension
Improve comfort and sleep

3) Strong anti-inflammatory drugs (Corticosteroids)

Not used routinely
Only in selected cases under strict medical supervision
Sometimes given as local injections

Benefits:

Rapid reduction of severe inflammation
Pain relief in difficult cases

⚠️ Must be used carefully due to potential side effects

4) Supportive treatment

Ice packs during the first 48–72 hours
- Reduce swelling and pain
Arm sling
- Limits movement
- Protects the joint
- Reduces pain

Important note

Drug treatment does not fix the dislocation itself. It is only used to control symptoms.

In some cases, especially:

Posterior dislocation
Unstable or complete dislocation

Patients may require reduction or surgical intervention.

⚠️ When does the condition become dangerous despite medication?

You should go to the emergency room immediately if any of the following symptoms appear:

Shortness of breath
Severe chest pain
Difficulty swallowing
Increasing or abnormal swelling

Surgical treatment of sternoclavicular joint dislocation (types and procedures)

Surgical treatment varies depending on several important factors, including:

Type of dislocation (anterior or posterior)
Severity (partial or complete)
Presence of compression on blood vessels or vital organs
Whether the injury is acute or chronic

Surgery is especially required in:

Dangerous posterior dislocations
Unstable dislocations
Chronic cases that do not respond to conservative treatment

1) Closed reduction

What is it?

It is the process of realigning the joint without a large surgical incision.

Procedure:

Performed under general anesthesia
The doctor attempts to reposition the clavicle using controlled traction and manipulation
External pressure or assistive tools may be used

Notes:

Mostly used in recent injuries (within days)
Lower success rate in posterior dislocations
May require stabilization afterward

2) Post-reduction stabilization

Even after successful reduction, stabilization is needed to protect the joint.

Methods include:

Arm sling
Figure-of-8 brace
In rare cases, temporary internal support devices

3) Open reduction surgery

What is it?

A direct surgical approach to expose the joint and restore alignment.

Steps:

A small incision over the joint
Exposure of the sternoclavicular joint
Removal of any tissue blocking reduction
Repositioning of the clavicle
Surgical fixation of the joint

4) Ligament reconstruction ⭐ (most important)

Concept:

Instead of relying only on the joint alignment, the ligaments that stabilize it are rebuilt.

Method:

Using a tendon graft from the patient’s own body (autograft)
Or using strong synthetic ligaments
The reconstruction is usually shaped in a figure-of-8 pattern between the clavicle and sternum

Goal:

Long-term stability
Prevention of recurrent dislocation

5) Fixation with screws or plates

Examples:

Special screws
Pins
Small metal plates

Important notes:

Not commonly used today
Due to the proximity of vital structures
Reserved for selected, carefully monitored cases

6) Medial clavicle resection

What is it?

Removal of a small portion of the inner end of the clavicle near the sternum.

When is it used?

Chronic cases
Persistent pain or arthritis
Failure of other treatments

Goal:

Reduce friction
Relieve pain
Improve mobility

7) Emergency posterior dislocation

In cases of compression symptoms:

Immediate surgical intervention is required
Sometimes involves vascular or thoracic surgeons
Goal is to relieve pressure on vessels or the airway and stabilize the joint safely

After surgery

Arm immobilization for 4–6 weeks
Gradual physical therapy
Avoid heavy lifting for a long period
Follow-up imaging to ensure stability

⚠️ Important:
Surgery in this area is highly delicate due to its proximity to:

The heart
The lungs
Major blood vessels

Tips for managing sternoclavicular joint dislocation

Proper management is essential to reduce pain, prevent complications, and speed recovery, especially because this joint is located near vital chest structures.