Bilateral asymmetrical traumatic sternoclavicular joint dislocations

Abstract

Unilateral and bilateral sternoclavicular joint (SCJ) dislocations are rare injuries. The difficulty in assessing this condition often leads to delay in diagnosis and treatment. We report a rare case of bilateral asymmetrical traumatic SCJ dislocations in a 45-year-old male. The right anterior SCJ dislocation was reduced in the emergency room (ER) and resulted in residual instability. The left posterior SCJ dislocation was asymptomatic and unnoticed for six months. It is important for ER physicians and orthopaedic surgeons to be able identify and treat this condition. All suspected SCJ dislocations should be evaluated by computed tomography (CT) scan for confirmation of the diagnosis and evaluation of both SCJs. Posterior SCJ dislocation is a potentially fatal injury and should not be overlooked due to the presence of other injuries. Surgical intervention is often necessary in acute and old cases.

Keywords: Case report; Dislocations; Emergency; Saudi Arabia; Shoulder; Sternoclavicular joint.

Figure 1:

Clinical image of the patient shows the deformity of the anterior dislocation of the right sternoclavicular joint (SCJ) and the absence of the normal shape of the left SCJ.

Figure 2:

Chest X-ray showing both clavicles on the same level with no obvious sternoclavicular joint injury.

Figure 3:

(A) A 3-D chest computed tomography scan which clearly shows the right anterior and left posterior sternoclavicular joint dislocations. (B) A 3-D chest computed tomography scan with a superior view of the dislocated right anterior and left posterior sternoclavicular joints.