Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute onset of left-sided chest wall pain following direct trauma to the shoulder girdle. Reports localized swelling and a visible prominence at the sternoclavicular junction. Denies dyspnea, dysphagia, or hoarseness. Pain is exacerbated by shoulder movement and supine positioning.
Clinical Examination Findings
Inspection reveals a palpable, firm, anteriorly displaced prominence of the medial clavicle on the left side. Localized tenderness to palpation at the sternoclavicular joint. No signs of retrosternal compression (no stridor, no venous congestion). Range of motion of the left shoulder is limited by pain, particularly with abduction and protraction. Neurovascular status of the left upper extremity is intact.
Treatment Protocol
Diagnosis of anterior sternoclavicular joint dislocation confirmed. Treatment is primarily conservative, consisting of ice application, non-steroidal anti-inflammatory drugs (NSAIDs), and immobilization using a sling for comfort. Avoidance of heavy lifting or overhead activities for 4-6 weeks. Referral to orthopedic surgery for follow-up and assessment of potential closed reduction if symptomatic.