Anatomy
Upper Limb
You are asked to review a 76 year old man who presents with pain and tenderness over the right sternoclavicular joint. You note the sternoclavicular joint is warm and there is marked erythema to the overlying skin. You suspect sternoclavicular joint septic arthritis. Which of the following synovial joint types best describes the sternoclavicular joint:
Answer:
The sternoclavicular joint is a synovial saddle-shaped 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](https://mrcemsuccess.com/wp-content/uploads/2016/12/Sternoclavicular-Joint.png)
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 |
