Sternoclavicular Joint

The sternoclavicular joint is the synovial articulation between the medial end of the clavicle and the sternal clavicular notch, together with the upper part of the subjacent first costal cartilage. The movements and structures including the articular disk are much like those of the acromioclavicular joint. The fibrocartilaginous layer is much thicker on the clavicular surface than the sternal notch. This joint is also a common seat of osteoarthritis. Men are more frequently affected than women. Motion pain, local tenderness, and enlargement of the joint are the main presenting symptoms. The involvement is usually unilateral, but the bilateral type is not rare.

Medial Sternoclavicular Joint

Fig. 9.29A, B Well-established osteoarthritis in the sternoclavicular joint. A Anteroposterior conventional X-ray tomogram of the sternum with a painful right sternoclavicular joint in a 49-year-old man reveals irregular subchondral erosions and sclerosis with small osteophytes in the bones about the joint (arrowheads). The joint is irregularly and eccentrically narrowed. B Anterior pinhole scan shows intense tracer uptake in the sternal margin (lower arrow) and the medial clavicular end (upper arrow) with eccentric articular narrowing. Note that the most intense tracer uptake is localized in the joint, the characteristic feature of osteoarthritis

Fig. 9.29A, B Well-established osteoarthritis in the sternoclavicular joint. A Anteroposterior conventional X-ray tomogram of the sternum with a painful right sternoclavicular joint in a 49-year-old man reveals irregular subchondral erosions and sclerosis with small osteophytes in the bones about the joint (arrowheads). The joint is irregularly and eccentrically narrowed. B Anterior pinhole scan shows intense tracer uptake in the sternal margin (lower arrow) and the medial clavicular end (upper arrow) with eccentric articular narrowing. Note that the most intense tracer uptake is localized in the joint, the characteristic feature of osteoarthritis joint space widening (Fig. 9.28A). Conventional tomography or CT is useful for the delineation of the true state of affairs (Fig. 9.29A).

Pinhole scintigraphy in the early stage shows an ill-defined area of minimally increased tracer uptake in the affected joint, vaguely denoting mild eburnation in the clavicular and sternal facets (Fig. 9.28B). With the progression of osteoarthritis, the articular space becomes obliterated and tracer uptake intensified. The uptake is typically more prominent at the sternal facet (Fig. 9.29B). Generally, the joint space is indiscernible even in the early stage and on a magnified scan, obviously due to the smallness of the joint and the ball-and-socket type of articular structure.

Osteoarthritis

Osteoarthritis

Thank you for deciding to learn more about the disorder, Osteoarthritis. Inside these pages, you will learn what it is, who is most at risk for developing it, what causes it, and some treatment plans to help those that do have it feel better. While there is no definitive “cure” for Osteoarthritis, there are ways in which individuals can improve their quality of life and change the discomfort level to one that can be tolerated on a daily basis.

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