Document Detail

Variations in normal sternoclavicular joints; a retrospective study to quantify SCJ asymmetry.
MedLine Citation:
PMID:  19308406     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: A wide degree of normal anatomical variation can occur at the sternoclavicular joint (SCJ). On occasion, this has led to concern for a pathological process, potentially resulting in a costly work-up, unnecessary patient worry and invasive diagnostic procedures such as biopsy. The purpose of this study was to determine the normal range of anatomical variation at sternoclavicular joints. MATERIALS AND METHODS: One hundred four consecutive patients with chest CT done at our institution were selected. Patients with clear SCJ pathology, chest wall abnormality, CT slice thickness greater than 5 mm and sternotomy wires, were excluded. Chart review was done and showed no SCJ symptoms/signs. We measured the SCJ space, maximum clavicular head diameter within the joint and the distance from manubrium to the anterior margin of the clavicular head. RESULTS: Left and right SCJ space ranged from 0.2 to 1.37 cm. The difference (delta or asymmetry) between left SCJ space and right SCJ space ranged from 0 (symmetrical) to 0.57 cm in 104 cases. Left and right clavicular head diameter ranged from 1.2 to 3.7 cm with left/right asymmetry (delta) ranging from 0 (symmetrical) to 1 cm. Manubrium to anterior margin of clavicular head ranged from 0.1 to 2.13 cm with delta ranging from 0 to 0.8 cm. Thirty-three patients demonstrated gas in the joint, five had poor articulation and four had calcification in the joint. CONCLUSION: Greater than 10% of patients show substantial asymmetry in the sternoclavicular joints, which may be misinterpreted as pathological. Gas in the joint is a common phenomenon therefore should not be an indication for further work-up in asymptomatic patients and likely excludes the presence of effusion.
Daymen Tuscano; Sima Banerjee; Michael R Terk
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Publication Detail:
Type:  Journal Article     Date:  2009-03-24
Journal Detail:
Title:  Skeletal radiology     Volume:  38     ISSN:  1432-2161     ISO Abbreviation:  Skeletal Radiol.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-08-27     Completed Date:  2009-11-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7701953     Medline TA:  Skeletal Radiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  997-1001     Citation Subset:  IM    
Emory Orthopaedics and Spine Center, Atlanta, NE 30329, USA.
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MeSH Terms
Aged, 80 and over
Middle Aged
Radiographic Image Interpretation, Computer-Assisted / methods*
Reproducibility of Results
Retrospective Studies
Sensitivity and Specificity
Sternoclavicular Joint / anatomy & histology*,  radiography*
Tomography, X-Ray Computed / methods*
Young Adult

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