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Anatomy

Upper Limb

Question 214 of 239

A 16 year old hockey player presents to the ED after colliding with another player during training. She is tender over the right clavicle and you note a deformity at the sternoclavicular joint, you suspect a sternoclavicular joint dislocation. Which of the following ligaments is the most important in stabilising the sternoclavicular joint:

Answer:

The strong costoclavicular ligament joins the proximal end of the clavicle to the first rib and costal cartilage and is the main stabilising force for the joint.

Sternoclavicular Joint

Anatomy / Upper Limb / Pectoral Region

Last Updated: 8th April 2019

Table: Anatomical Overview of the Sternoclavicular Joint

Joint Sternoclavicular joint
Type Synovial saddle-shaped joint
Articulations Proximal end of the clavicle; manubrium of sternum and first costal cartilage
Stabilisation Joint capsule, anterior and posterior sternoclavicular ligaments, interclavicular ligament and costoclavicular ligament

Joint Articulations

The sternoclavicular joint is a synovial saddle-shaped joint, occurring between the proximal end of the clavicle and the manubrium of the sternum and first costal cartilage.

Joint Ligaments

The sternoclavicular joint is surrounded by a joint capsule and reinforced by four ligaments; the anterior and posterior sternoclavicular ligaments, the interclavicular ligament and the costoclavicular ligament.

The strong costoclavicular ligament joins the proximal end of the clavicle to the first rib and costal cartilage and is the main stabilising force for the joint. Sternoclavicular joint dislocation is rare and requires significant force.

by Henry Vandyke Carter [Public domain], via Wikimedia Commons

Sternoclavicular Joint. (Image by Henry Vandyke Carter [Public domain], via Wikimedia Commons)

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  • Biochemistry
  • Blood Gases
  • Haematology
Biochemistry Normal Value
Sodium 135 – 145 mmol/l
Potassium 3.0 – 4.5 mmol/l
Urea 2.5 – 7.5 mmol/l
Glucose 3.5 – 5.0 mmol/l
Creatinine 35 – 135 μmol/l
Alanine Aminotransferase (ALT) 5 – 35 U/l
Gamma-glutamyl Transferase (GGT) < 65 U/l
Alkaline Phosphatase (ALP) 30 – 135 U/l
Aspartate Aminotransferase (AST) < 40 U/l
Total Protein 60 – 80 g/l
Albumin 35 – 50 g/l
Globulin 2.4 – 3.5 g/dl
Amylase < 70 U/l
Total Bilirubin 3 – 17 μmol/l
Calcium 2.1 – 2.5 mmol/l
Chloride 95 – 105 mmol/l
Phosphate 0.8 – 1.4 mmol/l
Haematology Normal Value
Haemoglobin 11.5 – 16.6 g/dl
White Blood Cells 4.0 – 11.0 x 109/l
Platelets 150 – 450 x 109/l
MCV 80 – 96 fl
MCHC 32 – 36 g/dl
Neutrophils 2.0 – 7.5 x 109/l
Lymphocytes 1.5 – 4.0 x 109/l
Monocytes 0.3 – 1.0 x 109/l
Eosinophils 0.1 – 0.5 x 109/l
Basophils < 0.2 x 109/l
Reticulocytes < 2%
Haematocrit 0.35 – 0.49
Red Cell Distribution Width 11 – 15%
Blood Gases Normal Value
pH 7.35 – 7.45
pO2 11 – 14 kPa
pCO2 4.5 – 6.0 kPa
Base Excess -2 – +2 mmol/l
Bicarbonate 24 – 30 mmol/l
Lactate < 2 mmol/l

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