Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute onset of left-sided chest wall and shoulder pain following direct trauma/indirect force to the shoulder girdle. Reports localized swelling, tenderness, and mechanical symptoms at the sternoclavicular (SC) joint. Denies dyspnea, dysphagia, or neurovascular compromise in the ipsilateral upper extremity.
Clinical Examination Findings
Inspection reveals visible deformity, soft tissue swelling, and ecchymosis over the left sternoclavicular joint. Palpation demonstrates point tenderness at the SC joint with palpable step-off or prominence. Range of motion of the left shoulder is limited by pain, particularly with abduction and cross-body adduction. Neurovascular status of the left upper extremity is intact with palpable radial/ulnar pulses and preserved distal sensation.
Treatment Protocol
Initial management includes immobilization with a sling or figure-of-eight brace for comfort. Application of ice packs for 20 minutes every 2-3 hours to reduce inflammation. Analgesics as prescribed. Referral for urgent CT imaging to rule out retrosternal displacement and associated mediastinal injury. Orthopedic follow-up scheduled for definitive management planning.