Radiological imaging is very important part of diagnosis making of sternoclavicular injuries. In addition to routine xray views,special views have been developed to confirm the injury. Sometimes imaging additional to Xrays might be necessary.
Anteroposterior and Lateral Views
Anteroposterior x-rays of the chest or sternoclavicular joint may show sternoclavicular joint displaced as compared with the normal side. Lteral x-rays are difficult to interpret due to overlapping of structures.
Heinig View
Patient is in supine position, the x-ray tube is placed approximately 30 inches from the involved sternoclavicular joint and the central ray is directed tangential to the joint and parallel to the opposite clavicle. The cassette is placed against the opposite shoulder and centered on the manubrium.
Hobbs View
The patient is seated at the x-ray table,leaning forward in a way that the nape of his flexed neck is almost parallel to the table and lower anterior rib cage against the cassette on the table. The x-ray source is above the nape of the neck.
Serendipity View
The patient is positioned on his back and the tube is tilted at a 40-degree angle off the vertical centering over sternum with cassette under patient’s upper shoulders and neck.
In children, the distance from the tube to the cassette is 45 inches and in adults 60 inches.
If the sternoclavicular joint is dislocated anteriorly, the affected clavicle will appear to be displaced and riding higher. If it is dislocated posteriorly, it will appear to be lower.
CT Scan
CT scan is the best modality to study the sternoclavicular joint injury. It clearly distinguishes injuries of the joint from fractures of the medial clavicle and defines minor subluxations of the joint. Opposite joint should also be included in the study for a comparitive analysis.
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What do you know or where can I find more information about a diagnosis of a sternoclavicular joint (bump) on the left side due to either arthritis or an osterchondroma?
There is no pain and there were regular x-rays taken that did not show enough information on it. A CT scan is the next step.
Can you give me some information or help with this question?
Thank you for your time.
There could be many causes for a swelling but the diagnosis is always individualized.
I think you are being investigated on the right track.
A CT should at least point to the nature of bump and source from which it is originating.
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