Clavicle Bone Lump The sternoclavicular (SC) joint is among the four joints that complete the shoulder. The joint is situated in the place where the clavicle (collarbone) matches the sternum (breastbone) at the base of the throat. Although not common, difficulties with the SC joint can arise in injury and other ailments.
Injuries to the SC joint generally result from motor vehicle accidents or participation in collision sports such as football. When these injuries can be debilitating, many are relatively small and will heal well without surgery. Very rarely, a tough blow to the SC joint may harm the very important organs and tissues that lie nearby. While this occurs, it is a serious injury that needs immediate medical care.
The SC joint may also be ruined through the years, as the protective tissue which covers the ends of these bones gradually wears away. This sort of degenerative change in the joint may result in stiffness, pain, and reduced movement at the arm and shoulder.
The SC joint is located where the clavicle and sternum meet. Reproduced and adapted from JF Sarwak, erectile dysfunction: Essentials of Musculoskeletal Care, ed. 4. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2010.
The sternoclavicular (SC) joint is that the linkage between the clavicle (collarbone) as well as the sternum (breastbone). The SC joint supports the shoulder and also is the only joint which connects the arm to the body.
Like the other joints in the body, the SC joint is covered with a smooth, silky substance called articular cartilage. This cartilage helps the bones slide easily together each other as you move your arm and shoulder. Tough bands of connective tissue called ligaments surround the SC joint, giving it strength and stability.
Immediately behind the SC joint lie several vital nerves and blood vessels, in addition to other vital structures such as the trachea (windpipe) and esophagus (which connects the throat to the stomach).
Injuries and osteoarthritis are the most frequent ailments associated with the SC joint.
Injuries to the SC joint may vary from a moderate sprain, in which the surrounding ligaments are stretched (the most commonly viewed accident ), to a fracture of the clavicle (collarbone) itself.
In rare situations, a strong blow to the shoulder can result in an injury in which the joint dislocates entirely from its regular position. Joint dislocations are categorized as either”anterior” or”posterior,” determined by the way in which the collarbone is pushed through the accident:
Although both kinds of dislocations are serious injuries, a posterior dislocation requires more urgent medical care. At a posterior dislocation, the very important structures behind the SC joint could be compressed, resulting in life threatening issues with breathing or blood circulation.
Causes of injury. The ligaments surrounding the SC joint are some of the most powerful in the body, so it requires a great deal of force to cause an injury. Normally, accidents to the joint are caused by some Kind of high-impact event, like a:
- Collision or challenging fall in a contact sport like soccer or football
- Motor vehicle accident
Because of the substantial force required to cause an injury, patients may also have additional injuries to the torso, airways, and extremities. Sometimes, harm to the SC joint is overlooked initially because those other injuries need urgent attention.
Osteoarthritis is a degenerative”wear and tear” type of arthritis which occurs most frequently in people 50 years of age or older, though it may occur in younger individuals, too.
In osteoarthritis, the smooth articular cartilage which covers the SC joint gradually wears away. As the cartilage wears away, it becomes frayed and rough, and the protective distance between the bones decreases. This can lead to painful bone rubbing on bone and may also cause a nasal prominence around the joint.
Osteoarthritis develops slowly and the stiffness and pain it triggers worsens over time.
Other ailments associated with the SC joint include:
Inflammatory conditions, such as rheumatoid arthritis
Additionally, some patients may experience small movement or popping of the bone from place even without some type of injury. This condition is called”subluxation” and seems to be limited to those men and women that are considered”loose jointed.”
The most common symptom of an SC joint disorder is pain in the area where the clavicle meets the sternum. This pain will be present with a sprain but will probably be much sharper in the case of a fracture or dislocation–especially when you attempt to move your arm.
Other symptoms and signs may include:
- Swelling, bruising, or tenderness over the joint
- A crunching or grinding noise when you attempt to move your arm
- Restricted selection of motion in the arm
- With an inflammatory illness, such as rheumatoid arthritis, you may have back pain in other joints in your body
- With a joint infection, there may be inflammation within the joint and you might have fever, chills, or night sweats. If
you experience any of the symptoms of a joint disease, it is very important to get medical care straight away.
Your physician will talk with you about your health history and basic wellbeing and inquire about your symptoms. He or she’ll want to know when your pain began and if there’s a history of accident or injury.
Your physician will look for visible signs of deformity or even a bump over the joint. He or she’ll then perform a careful evaluation of your shoulder region. During the exam, your doctor will:
- Search for swelling, swelling, or redness over the joint
- Check range of motion in your arm
- Check your pulse at the elbow and wrist to make sure that there is good blood flow to your hands and palms.
X-rays. X-rays provide images of compact structures, such as bone. Your health care provider will order x-rays your chest and shoulder from a number of different angles to help confirm the diagnosis and rule out other underlying shoulder conditions.
Computerized tomography (CT) scan. This imaging analysis is more comprehensive than the usual plain x-ray. Your physician may order a CT scan to better assess your harm and to help differentiate a sprain from a dislocation or even a fracture.
Other imaging research. Depending upon your specific problem, your doctor may order additional imaging studies, such as a magnetic resonance imaging (MRI) scan or bone scan.
Typically, ailments of the SC joint can be treated without operation. Nonsurgical treatment may include:
Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, can decrease swelling and pain in the joint.
If you have osteoarthritis or an inflammatory illness, your physician can also recommend strong anti-inflammatory agents called corticosteroids, which can be injected directly into the joint. Corticosteroids can provide temporary relief of pain and swelling.
Immobilization. If you have an injury, your doctor may recommend that you wear a shoulder to restrict arm movement and permit for healing. The duration of time you will need to wear the sling depends upon the severity of your injury.
The physician may recommend that individuals using SC joint arthritis prevent the activities that bring on painful symptoms.
For patients who experience nontraumatic dislocation of the joint (subluxation), the physician can also recommend avoiding the actions that make the joint”pop.”
Closed reduction. When you’ve got a joint dislocation, your doctor may try to control the clavicle back into position without making an incision in the skin. This procedure is referred to as a closed reduction. A closed reduction is usually performed in the operating area. You may be given either general anesthesia or a muscle relaxant.
Some anterior dislocations may”pop” back out following closed reduction. If that is not recognized until several days or even months following the injury, the anterior dislocation is left alone and many patients report no pain and normal shoulder function–even though there may be a deformity or bump within the joint.
Because a posterior dislocation can compress the vital structures on the other side of the joint, it usually requires urgent loss. Getting the joint back into the appropriate position is vital. During closed loss to get a posterior dislocation, a thoracic physician may be available to deal with potential complications between the structures at the torso.
Open reduction. In some cases, closed reduction to get a posterior dislocation isn’t successful. In this situation, your physician might have to perform an open reduction of the SC joint. To do this, he or she will make an incision and put the joint back in position under direct vision. In rare situations, the SC joint may dislocate repeatedly after reduction. These patients may need reconstructive surgery to stabilize the joint.
Additional processes. For patients with a disease in the SC joint, a direct operation is usually necessary to start the joint and fix the infection. This will be followed by a course of antibiotics.
Surgery for gout can also be performed, even though it’s rarely required. If your pain and stiffness can’t be managed with nonsurgical treatment, however, your doctor may perform a procedure to remove bone from the arthritic and painful end of the clavicle. This will allow more space for movement.
After a fracture or dislocation of the SC joint, then your arm can be immobilized in a sling for as much as 6 weeks or more. Even when the sling is removed, you will still have restrictions on lifting. For example, you may be limited from elevator anything more than a glass of plain water for up to several months. These restrictions hold accurate following operation too. Immobilizing and not utilizing your arm allows the healing process to happen.
During your recovery, certain exercises will help restore movement and strengthen your shoulder. Your doctor may provide you with a house treatment program or urge that you operate with a therapist.