Sternoclavicular Joint

Today in clinic a gentleman came in with anterior chest pain. After the big MI / PE / Pneumo rule out, it appeared to be musculoskeletal. He had a history of fall with trauma to anterior chest 5 months ago.

He had very reproducible pain at sternoclavicular joint. I rarely think to ultrasound this, but it is as scannable as any AC joint.

Jacobsen does a nice piece on anterior / posterior dislocation and joint infection. He doesn't do much on routine osteolysis @ the SC joint. He does do a piece on osteolysis @ AC joint, which is a decent approximation of appearance on scan.

I thought I'd draw the simple anatomy.
I wish I could post the Jacobsen "AC Osteolysis" picture to give you a sense of what this gentlemen with SC joint pathology looked like. They were uncannily similar: Ligamentous swelling, erosion around sterum and clavicle tips, hypoechogenecity between bone tips. Rather than get sued for copyright infringement, I thought I'd draw out the image.