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Posterior sternoclavicular ligament

The posterior sternoclavicular ligament is a strong fibrous band that reinforces the posterior aspect of the sternoclavicular (SC) joint. It extends from the posterior edge of the sternal manubrium to the posterior surface of the medial clavicle, forming one of the key stabilizers of the SC joint. This ligament prevents excessive anterior and posterior displacement of the clavicle, maintaining joint congruity during shoulder movements. Compared with the anterior sternoclavicular ligament, it is thicker and stronger, providing greater resistance to posterior translation.

Synonyms

  • Posterior SC ligament

  • Sternoclavicular posterior ligament

  • Dorsal sternoclavicular ligament

Function

  • Reinforces the posterior sternoclavicular joint capsule

  • Prevents anterior and posterior displacement of the clavicle

  • Stabilizes the SC joint during shoulder elevation, protraction, and retraction

  • Contributes to upper limb girdle stability by anchoring clavicle to sternum

MRI Appearance

T1-weighted images:

  • Appears as a low-signal (hypointense) linear structure posterior to the SC joint

  • Surrounded by intermediate signal intensity soft tissues and hyperintense fat planes

  • Useful for assessing integrity and tears

T2-weighted images:

  • Ligament remains low signal intensity relative to surrounding fat and joint fluid

  • Acute injury may show discontinuity, thickening, or periligamentous high signal indicating edema or hemorrhage

STIR (Short Tau Inversion Recovery):

  • Normal ligament stays low signal

  • Edema, inflammation, or acute injury in surrounding tissues appears bright hyperintense

  • Helpful in detecting acute sprains, trauma, or inflammatory arthropathy

T1 Post-Contrast (Gadolinium-enhanced):

  • Normal ligament shows no significant enhancement

  • Pathological cases (e.g., capsulitis, infection, inflammatory arthritis) may demonstrate periligamentous or capsular enhancement

CT Appearance

Non-contrast CT:

  • The ligament itself is not directly visible but inferred by its anatomic location

  • Adjacent clavicle and manubrium cortical margins are well delineated

  • Calcifications (rare) in chronic degeneration may appear hyperdense

Contrast-enhanced CT:

  • Soft tissue contrast helps outline the posterior joint capsule and ligament region

  • Useful for evaluating osseous avulsion, fractures, and joint alignment abnormalities

MRI image

Posterior sternoclavicular ligament anatomy MRI coronal image -img-00000-00000

CT image

Posterior sternoclavicular ligament anatomy CT axial image -img-00000-00000

MRI image

posterior sternoclavicular ligament axial mri image