Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute onset of left-sided chest wall pain and localized swelling following direct trauma to the shoulder girdle. Reports mechanical instability, pain with shoulder protraction/retraction, and difficulty with overhead reaching. Denies dyspnea, dysphagia, or neurovascular compromise in the left upper extremity.
Clinical Examination Findings
Physical examination of the left sternoclavicular (SC) joint reveals localized tenderness, palpable step-off deformity, and visible prominence of the medial clavicle. Range of motion of the left shoulder is limited by pain. Neurovascular status of the left upper extremity is intact with palpable distal pulses and normal capillary refill. No signs of mediastinal compression or respiratory distress.
Treatment Protocol
Initial management includes immobilization with a sling or figure-of-eight brace to stabilize the SC joint. Application of ice packs for 20 minutes every 2-3 hours to reduce edema. Analgesics (NSAIDs) prescribed for pain control. Orthopedic follow-up scheduled for repeat clinical assessment and consideration of closed reduction if indicated.