Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute onset of localized pain and swelling over the sternoclavicular (SC) joint following [mechanism of injury, e.g., direct blow/indirect force]. Reports exacerbation of pain with shoulder movement, abduction, or protraction. Denies dyspnea, dysphagia, or hoarseness. No history of prior SC joint instability.
Clinical Examination Findings
Inspection reveals visible deformity or prominence at the SC joint. Palpation demonstrates point tenderness, crepitus, and potential step-off deformity. Assessment of neurovascular status of the ipsilateral upper extremity is intact (distal pulses 2+, capillary refill <2s, sensation intact). Evaluation for posterior dislocation includes assessment for mediastinal compression signs (stridor, venous congestion, dysphagia).
Treatment Protocol
Management initiated with immobilization using a sling or figure-of-eight brace. Analgesia provided via NSAIDs. For anterior dislocations, conservative management is standard. For symptomatic posterior dislocations, urgent orthopedic consultation for closed reduction under sedation or surgical stabilization is indicated. Follow-up imaging (CT scan) recommended to rule out retrosternal structures injury.