Background and indications: The sternoclavicular (SC) joint is the diarthrodial articulation between the axial and appendicular skeletons. It is subject to the same disease processes that occur in other joints, including degenerative arthritis, rheumatoid arthritis, infection, and subluxation. Most of these conditions present with swelling of the joint, which may be associated with pain and/or tenderness. A few studies have been published addressing therapeutic injections of the SC joint. Indications for injections of the SC joint at present are done empirically for reasons similar to other joint injections. SC joint pain is relatively uncommon compared to other sources of shoulder/pectoral girdle pain.

Anatomy: The SC joint is formed by the articulation of the proximal end of the clavicle with the clavicular fossa in the superior lateral aspect of the sternum (Fig. 63.1). The proximal end of the clavicle is slightly elevated, and thus can easily be palpated at the SC joint. With scapular retraction, the sternal side of the joint becomes more easily palpated. The SC joint is rather shallow, and caution should be taken not to overpenetrate the joint to prevent traversing the joint and entering underlying structures. The SC joint is an atypical synovial joint; like the acromioclavicular joint, the articular surfaces are covered with fibrocartilage. The medial end of the clavicle articulates with the manubrium and first costal cartilage. The capsule is thickened anteriorly and posteriorly to form the SC ligaments.