HSS What's the Diagnosis Case 97

What’s the Diagnosis – Case 97

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What’s the Diagnosis – Case 97

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What’s the Diagnosis – Case 97

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What’s the Diagnosis – Case 97

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What’s the Diagnosis – Case 97

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What’s the Diagnosis – Case 97

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What’s the Diagnosis – Case 97

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Findings Serendipity view shows symmetric alignment of the sternoclavicular (SC) joints. CT study is slightly limited as the study was initially protocolled for a shoulder study and to prevent against rescanning the patient retro-recon images were post-processed. The SC joints are symmetric in position with soft tissue swelling about the right SC joint. The MRI shows an apophyseal injury of the right medial clavicle with partial disruption of the capsule but no displacement of the apophyseal plate. The SC fibrocartilage disc/meniscus has sustained a low grade injury but is also not posteriorly displaced.

What’s the Diagnosis – Case 97

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What’s the Diagnosis – Case 97

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What’s the Diagnosis – Case 97

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What’s the Diagnosis – Case 97

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What’s the Diagnosis – Case 97

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What’s the Diagnosis – Case 97

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What’s the Diagnosis – Case 97

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Diagnosis: Medial Clavicle Apophyseal Injury Sternoclavicular joint injuries are uncommon but frequently involve an anterior dislocation. In the setting of a higher energy mechanism a posterior dislocation can be caused. This is of importance because with posterior displacement there can be impingement upon the great vessels in the mediastinum. The medial clavicular apophsyis is not mature until the early to mid 20’s and in the skeletally immature patient the apophysis is typically the site of injury. As the apophysis is not able to be perceived on radiographs or CT, those modalities will show a normal alignment. Only MRI can show displacement of the apophysis and articular disc which are imperative to evaluate as particularly posterior displacement could lead to cosmetic deformity as well as the aforementioned impingement of the great vessels.

What’s the Diagnosis – Case 97

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