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Sternoclavicular joint

The sternoclavicular joint (SCJ) is the synovial articulation between the sternal end of the clavicle and the manubrium of the sternum, with a small contribution from the first costal cartilage. It is a saddle-type synovial joint, but functionally acts as a ball-and-socket joint, allowing a wide range of shoulder girdle movements.

The joint surfaces are incongruent and separated by a fibrocartilaginous articular disc, which improves stability and load transmission. The SCJ is the only true articulation connecting the upper limb to the axial skeleton, making it biomechanically critical.

Ligaments and Supporting Structures:

  • Anterior and posterior sternoclavicular ligaments: reinforce capsule

  • Interclavicular ligament: spans both clavicles across jugular notch

  • Costoclavicular ligament: anchors clavicle to first rib, limiting elevation

  • Articular disc: stabilizes joint, cushions axial loading

The SCJ allows movements of elevation, depression, protraction, retraction, and axial rotation of the clavicle, coordinated with shoulder girdle motion.

Clinically, it is important in trauma (dislocations), arthritis, infection, and inflammatory arthropathies. Posterior dislocations are rare but potentially life-threatening due to proximity to great vessels, trachea, and esophagus.

Synonyms

  • SC joint

  • Articulatio sternoclavicularis

  • Sternoclavicular articulation

Function

  • Provides the only bony articulation of upper limb to the trunk

  • Allows multiaxial movement of the clavicle, essential for full shoulder motion

  • Stabilizes shoulder girdle through ligamentous support and articular disc

  • Serves as a load transfer point between upper limb and axial skeleton

MRI Appearance

T1-weighted images:

  • Bone marrow: intermediate signal

  • Cortical bone: hypointense

  • Articular disc: low signal intensity

  • Joint capsule and ligaments visible as hypointense bands

T2-weighted images:

  • Synovial fluid: hyperintense

  • Cartilage: intermediate to high signal

  • Useful for detecting effusions, cartilage thinning, or degeneration

PD-FS (Proton Density Fat-Suppressed):

  • Excellent for labrum-like disc, capsule, and ligament visualization

  • Shows bone marrow edema, synovitis, capsular injury, and subtle cartilage defects as hyperintense signals

  • Ideal for detecting early inflammatory arthritis and post-traumatic changes

STIR:

  • Fat suppression enhances detection of bone marrow edema, infection, or inflammation

  • Useful in suspected osteomyelitis or septic arthritis

T1 Post-Gadolinium (Gd-enhanced MRI):

  • Enhances synovium, capsule, and inflamed soft tissues

  • Detects synovitis, abscesses, pannus, or tumor involvement

  • Differentiates infective vs inflammatory arthritis

MRI Non-Contrast 3D Imaging:

  • Provides 3D visualization of the SCJ, disc, and relationship with adjacent mediastinal structures

  • Helpful in surgical and trauma planning

CT Appearance

Non-contrast CT:

  • Excellent for bony detail — cortical margins, fractures, erosions, and degenerative changes

  • Useful for evaluating calcification, ankylosis, or subtle fractures

CT Post-Contrast (CT Arthrography / Contrast-enhanced CT):

  • Contrast outlines joint capsule, effusion, or inflammatory pannus

  • Helps detect synovitis, septic arthritis, erosive arthropathy, or tumor invasion

  • Multiplanar and 3D reconstructions allow precise evaluation of dislocation or surgical planning

MRI image

Sternoclavicular joint anatomy MRI coronal image -img-00000-00000

CT images

Sternoclavicular joint anatomy ct axial image -img-00000-00000

CT images

Sternoclavicular joint anatomy ct coronal image -img-00000-00000

X Ray image

Sternoclavicular joint x ray Anatomy, Location and Imaging Appearance -img-00000-00000