Sternoclavicular Joint Pain and Instability: Difference between revisions
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This article reviews sternoclavicular instability and pain. See [[Sternoclavicular Joint]] for a review of the anatomy. The sternoclavicular joint (SCJ) is inherently unstable. The main stabilisers are the strong extrinsic ligaments, and to a lesser extent the muscular envelope. | |||
==Classification of Instability== | |||
SCJ instability can be structure or non-structural, and causative factors may be traumatic, atraumatic, neurological, or a combination. Other than an acute first time event, instability may be persistent or recurrent. The direction of displacement of the medial clavicle can be anterior, posterior, superior, or inferior. | |||
Stanmore's triangle system, traditionally used for describing glenohumeral joint instability, has also been used to describe SCJ instability. There are three factors that are represented as points in a triangle: type I traumatic structural, type II atraumatic structure, and type III muscle patterning (neuromuscular) non-structural. The groups exist as a spectrum, and patients can have features of two groups, and/or move to a different pattern. With type I, there is a history of trauma such as SCJ dislocation or medial clavicular fracture. In Type II there is a structural capsular pathology without a history of "macro"-trauma but there may be micro-traumatic change. In type III there is a pathological muscle-pattern with inappropriate activation of the pectoralis major clavicular and sternal parts. This is most noticeable with eccentric overhead activities. Muscle patterning can be difficult to detect. | |||
==Resources== | |||
See Garcia et al for an open access review on sternoclavicular joint instability. <ref>{{#pmid:32801951}}</ref> Also an older open access review by Sewell et al.<ref>{{#pmid:23723264}}</ref> | See Garcia et al for an open access review on sternoclavicular joint instability. <ref>{{#pmid:32801951}}</ref> Also an older open access review by Sewell et al.<ref>{{#pmid:23723264}}</ref> | ||
Revision as of 16:19, 12 April 2021
This article reviews sternoclavicular instability and pain. See Sternoclavicular Joint for a review of the anatomy. The sternoclavicular joint (SCJ) is inherently unstable. The main stabilisers are the strong extrinsic ligaments, and to a lesser extent the muscular envelope.
Classification of Instability
SCJ instability can be structure or non-structural, and causative factors may be traumatic, atraumatic, neurological, or a combination. Other than an acute first time event, instability may be persistent or recurrent. The direction of displacement of the medial clavicle can be anterior, posterior, superior, or inferior.
Stanmore's triangle system, traditionally used for describing glenohumeral joint instability, has also been used to describe SCJ instability. There are three factors that are represented as points in a triangle: type I traumatic structural, type II atraumatic structure, and type III muscle patterning (neuromuscular) non-structural. The groups exist as a spectrum, and patients can have features of two groups, and/or move to a different pattern. With type I, there is a history of trauma such as SCJ dislocation or medial clavicular fracture. In Type II there is a structural capsular pathology without a history of "macro"-trauma but there may be micro-traumatic change. In type III there is a pathological muscle-pattern with inappropriate activation of the pectoralis major clavicular and sternal parts. This is most noticeable with eccentric overhead activities. Muscle patterning can be difficult to detect.
Resources
See Garcia et al for an open access review on sternoclavicular joint instability. [1] Also an older open access review by Sewell et al.[2]
References
- ↑ Garcia et al.. Sternoclavicular Joint Instability: Symptoms, Diagnosis And Management. Orthopedic research and reviews 2020. 12:75-87. PMID: 32801951. DOI. Full Text.
- ↑ Sewell et al.. Instability of the sternoclavicular joint: current concepts in classification, treatment and outcomes. The bone & joint journal 2013. 95-B:721-31. PMID: 23723264. DOI.
