The sternoclavicular (SC) joint, where the clavicle meets the sternum, plays a vital role in shoulder movement and upper body stability. Arthritis of this joint can cause significant swelling, discomfort and functional limitations. This article explores the symptoms, causes, assessment, and treatment options for sternoclavicular joint arthritis. 

Sternoclavicular Joint Arthritis 

Patients with SC joint arthritis typically report:

  • Localised Pain: Pain at the base of the neck or upper chest, often worsening with arm movement or activities involving the shoulder. Sometimes, pain occurs with deep breathing or coughing. 
  • Swelling and tenderness: Visible or palpable swelling over the SC joint, inside the collarbone and above the sternum is common. Touching this area reproduces pain. 
  • Stiffness: Reduced range of motion in the shoulder due to discomfort in the chest or collarbone is often seen. 
  • Mechanical Sensation: Abnormal clicking, popping or grinding can be felt during arm or shoulder movement.
young man touching his sternoclavicular joint

Assessment of SC Joint Arthritis

A thorough clinical evaluation is essential to diagnose SC joint arthritis and identify the underlying cause.

Your doctor will thoroughly examine your pain location, characteristics and aggravating and relieving factors. A history of trauma or systemic disease is also critical, as is a family history of inflammatory arthritis or autoimmune disease. 

You will need a physical examination to check for swelling, redness or asymmetry of the SC joint. Often, SC joint arthritis is tender to the touch. Movements of the shoulder and neck usually aggravate arthritis from the SC joint. 

Your doctor must examine other areas to ensure that other pathologies do not drive your pain. Other common causes of neck and upper chest pain include the following: 

  • Disc degeneration in the neck 
  • Cardiac or pulmonary disease 

Imaging for the diagnosis of sternoclavicular joint arthritis 

Imaging studies are crucial in confirming the diagnosis and ruling out other conditions.

X-rays

An X-ray can help detect joint space narrowing, osteophyte formation, or calcification and determine whether the SC joint is in the correct position. 

MRI

MRI offers insights into soft tissue structures, inflammation, and potential infections of the SC joint. 

Ultrasound

Ultrasound can identify SC joint effusion, guide aspiration or injection, and assess soft tissue abnormalities.

Blood Tests

Blood tests help exclude an autoimmune cause or infection of the SC joint. 

Other causes of pain and swelling in the SC joint

Swelling of the SC joint is not just from osteoarthritis and can result from various causes, including:

  • Inflammatory Arthritis: An autoimmune condition that leads to joint inflammation.
  • Infection (Septic Arthritis): Bacterial infection of the joint causes redness, warmth, and pain.
  • Trauma: Injury to the joint from direct impact or dislocation.
  • Tumors: Rarely, swelling may result from benign or malignant growths near the joint.

Treatment Options for SC Joint Arthritis

Generally, we start with simple treatments for SC joint arthritis. First, we recommend modifying overhead activity, such as lifting weights, to avoid exacerbating symptoms. Physical therapy can help by increasing joint mobility, strengthening supporting muscles, and improving posture. 

Medication such as NSAIDs can improve pain from SC joint osteoarthritis. 

Sometimes, in cases of severe or persistent pain, we perform an ultrasound-guided injection. We generally use cortisone due to its potent anti-inflammatory effects, but we can sometimes use other injectables, such as platelet-rich plasma. As the SC joint lies close to other critical structures, like the ascending aorta, this injection must be performed with ultrasound guidance to ensure accuracy. 

Surgical Treatment

Surgery is reserved for severe cases where conservative measures fail:

  • Resection Arthroplasty: Removal of the medial end of the clavicle to alleviate pain.
  • Joint Fusion: Rarely performed but considered for chronic instability or severe arthritis.

Other Frequently Asked Questions about Sternoclavicular Joint Arthritis 

Can sternoclavicular joint arthritis cause neck or shoulder pain? 

Yes. Pain usually resides at the SC joint. However, in some cases, pain may radiate to the base of the neck and front of the shoulder. 

Final word from Sportdoctorlondon on Sternoclavicular Joint Arthritis 

Sternoclavicular joint arthritis, while less common than other forms, can cause significant discomfort and limit upper body function. Early diagnosis is key. Conservative treatments, including medications, physical therapy, and injections, often provide relief, while surgical options are available for advanced cases. If you experience persistent sternoclavicular joint swelling, consult a sports medicine professional to get an early diagnosis and treatment plan.

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