Sternoclavicular joint

The shoulder complex consists of four distinct articulations the glenohumeral joint, the acromioclavicular joint, the sternoclavicular joint, and the scapulothoracic articulation. The wide range of motion of the shoulder (exceeding a hemisphere) is the result of synchronous, simultaneous contributions from each joint The most important function of the shoulder is arm elevation. Several investigators have attempted to relate glenohumeral and scapulothoracic motion during arm elevation in various planes... 

MagneyJE, Flynn DM, Parsons JAetal (1993) Anatomical mechanisms explaining damage to pacemaker leads defibrillator leads and failure of central venous catheters adjacent to the sternoclavicular joint. Pacing Clin Electrophysiol 16(3 Pt 1) 445 57... 

The sternoclavicular joint, one of the true joints of the shoulder girdle, may affect rib cage motion either primarily, via the manubrium and ligamentous attachments to the costal cartilage, or secondarily, because of the position of the upper extremity. 

The locations of the tender points of the anterior rib cage are shown in Figure 72-1. The tender point for the first rib is lateral to the sternum, at the level of the angle of Louis, just below the sternoclavicular joint. The tender point for the second rib is in the mid-clavicular line at the level of the second rib interspace. 

The sternoclavicular joint has a sellar or saddle-shaped articular surface, frequently with an interposed meniscus. This joint affords three planes of movement of the clavicle, in a frontaf and horizontal plane, as well as rotation on its long axis. 

The sternoclavicular joint moves cephalad and caudad in the frontal plane, moves ven-trad and dorsad in the horizontal plane, and rotates on its mechanical axis (Fig. 79-2). All cephalad-caudad and ventrad-dorsad movements are accompanied by translatory slides. 

The clavicle moves during most shoulder activity. Dysfunctions in clavicular motion can interfere with normal shoulder movement. The combined axial rotation of the sternoclavicular joint (30 degrees) and the acromioclavicular joint (30 degrees) allows the normal 60 degrees of rotation of the scapula on full abduction of the shoulder. 

In abduction, the distal end of the clavicle moves superiorly and the proximal end moves inferi-orly. The physician tests motion in abduction by placing her index finger on the clavicular head next to the sternum while the patient is supine, the physician then asks the patient to shrug (Fig. 80-2]. A caudad movement should be palpated with normal motion at the sternoclavicular joint... 

Restricted Abduction of the Sternoclavicular Joint (Adduction Dysfunction)... 

FIG. 85-1 Muscle energy treatment for restricted abduction of the sternoclavicular joint. 

FIG. 88-12 HVLA thrusting technique for somatic dysfunction of the sternoclavicular joint. 

Any type of arthritis may involve any of the shoulder girdle joints. The sternoclavicular joint is most commonly affected. Osteoarthritis of the glenohumeral joint is less common than in some of the other upper extremity joints. 

Clinical Anatomy 190 Osseous and Articular Anatomy 190 Glenohumeral Joint 190 Acromioclavicular Joint 191 Sternoclavicular Joint 193 Scapulothoracic Plane 193 Muscles and Tendons 193 Rotator Cuff 193... 

Hiramuro-Shoji F, Wirth MA, Rockwood CA et al (2003) Atraumatic conditions of the sternoclavicular joint. J Shoulder Elbow Surg 12 79-88... 

---