The sternoclavicular joint or sternoclavicular articulation is a synovial

saddle The saddle is a supportive structure for a rider of an animal, fastened to an animal's back by a girth. The most common type is equestrian. However, specialized saddles have been created for oxen, camels and other animals. It is not kno ...

joint A joint or articulation (or articular surface) is the connection made between bones, ossicles, or other hard structures in the body which link an animal's skeletal system into a functional whole.Saladin, Ken. Anatomy & Physiology. 7th ed. McGraw ...

between the manubrium of the sternum, and the

clavicle The clavicle, or collarbone, is a slender, S-shaped long bone approximately 6 inches (15 cm) long that serves as a strut between the shoulder blade and the sternum (breastbone). There are two clavicles, one on the left and one on the rig ...

, as well as the first

rib In vertebrate anatomy, ribs ( la, costae) are the long curved bones which form the rib cage, part of the axial skeleton. In most tetrapods, ribs surround the chest, enabling the lungs to expand and thus facilitate breathing by expanding the ches ...

. The joint possesses a

joint capsule In anatomy, a joint capsule or articular capsule is an envelope surrounding a synovial joint.articular disk The articular disk (or disc) is a thin, oval plate of fibrocartilage present in several joints which separates synovial cavities. This separation of the cavity space allows for separate movements to occur in each space. The presence of an articula ...

, and is reinforced by multiple ligaments.

Structure

The joint is structurally classed as a synovial

plane joint A plane joint (arthrodial joint, gliding joint, plane articulation) is a synovial joint which, under physiological conditions, allows only gliding movement. Plane joints permit sliding movements in the plane of articular surfaces. The opposed sur ...

and functionally classed as a diarthrosis and multiaxial joint. It is composed of two portions separated by an

articular disc The articular disk (or disc) is a thin, oval plate of fibrocartilage present in several joints which separates synovial cavities. This separation of the cavity space allows for separate movements to occur in each space. The presence of an articula ...

fibrocartilage Fibrocartilage consists of a mixture of white fibrous tissue and cartilaginous tissue in various proportions. It owes its inflexibility and toughness to the former of these constituents, and its elasticity to the latter. It is the only type of ...

. The joint is formed by the sternal end of the clavicle, the clavicular notch (the superior and lateral part of the sternum), and (the superior surface of) the

cartilage Cartilage is a resilient and smooth type of connective tissue. In tetrapods, it covers and protects the ends of long bones at the joints as articular cartilage, and is a structural component of many body parts including the rib cage, the neck an ...

of the

first rib The rib cage, as an enclosure that comprises the ribs, vertebral column and sternum in the thorax of most vertebrates, protects vital organs such as the heart, lungs and great vessels. The sternum, together known as the thoracic cage, is a semi-r ...

(visible from the outside as the

suprasternal notch The suprasternal notch, also known as the fossa jugularis sternalis, jugular notch, or Plender gap, is a large, visible dip in between the neck in humans, between the clavicles, and above the manubrium of the sternum. Structure The suprasternal ...

). The articular surface of the clavicle is larger than that of the sternum, and is invested with a layer of cartilage, which is considerably thicker than that of the sternum. The joint receives arterial supply via branches of the

internal thoracic artery In human anatomy, the internal thoracic artery (ITA), previously commonly known as the internal mammary artery (a name still common among surgeons), is an artery that supplies the anterior chest wall and the breasts. It is a paired artery, with on ...

, and of the

suprascapular artery The suprascapular artery is a branch of the thyrocervical trunk on the neck. Structure At first, it passes downward and laterally across the scalenus anterior and phrenic nerve, being covered by the sternocleidomastoid muscle; it then crosses t ...

. It is innervated via the medial supraclavicular nerve (superficially), and the

nerve to subclavius The subclavian nerve, also known as the nerve to the subclavius, is small branch of the upper trunk of the brachial plexus. It contains axons from C5 and C6. The subclavian nerve innervates the subclavius muscle. Structure The subclavian ner ...

(deeply).

Joint capsule

The joint capsule is thickened anteriorly and posteriorly, but is meagre superiorly and (especially) posteriorly, where it consists mostly of

loose areolar connective tissue Loose connective tissue, sometimes called areolar tissue, is a cellular connective tissue with thin and relatively sparse collagen fibers. Its ground substance occupies more volume than the fibers do. It has a viscous to gel-like consistenc ...

Articular disc

The joint features a

fibrocartilaginous Fibrocartilage consists of a mixture of white fibrous tissue and cartilaginous tissue in various proportions. It owes its inflexibility and toughness to the former of these constituents, and its Elasticity (physics), elasticity to the latter. It ...

which completely divides the joint to form two articular compartments. the disc acts to increase the range of movement of the joint.

Ligaments

The joint is reinforced by two intrinsic and two extrinsic ligaments. The

costoclavicular ligament The costoclavicular ligament, also known as the rhomboid ligament or Halsted's ligament, is a ligament of the shoulder girdle. It is short, flat, and rhomboid in form. It is the major stabilizing factor of the sternoclavicular joint and is the a ...

is the main limitation to movement, and therefore the main stabilizer of the joint. *

Anterior sternoclavicular ligament The anterior sternoclavicular ligament is a broad band of fibers attached to the clavicle above, and to the manubrium below. The ligament overlies the anterior (front) surface of sternoclavicular joint. Anatomy Attachments It is attached sup ...

(intrinsic) *

Posterior sternoclavicular ligament The posterior sternoclavicular ligament is a band of fibers, covering the posterior surface of the sternoclavicular joint. It is attached above to the upper and back part of the sternal end of the clavicle, and, passing obliquely downward and med ...

(intrinsic) *

Costoclavicular ligament The costoclavicular ligament, also known as the rhomboid ligament or Halsted's ligament, is a ligament of the shoulder girdle. It is short, flat, and rhomboid in form. It is the major stabilizing factor of the sternoclavicular joint and is the a ...

(extrinsic) *

Interclavicular ligament The interclavicular ligament is a flattened band, which varies considerably in form and size in different individuals, it passes in a curved direction from the upper part of the sternal end of one clavicle to that of the other, and is also attache ...

(extrinsic)

Function

The sternoclavicular joint allows movement of the

in three planes, predominantly in the

anteroposterior Standard anatomical terms of location are used to unambiguously describe the anatomy of animals, including humans. The terms, typically derived from Latin or Greek roots, describe something in its standard anatomical position. This position prov ...

and vertical planes, although some rotation also occurs. A description of movement would be elevation and depression. Muscles do not directly act on this joint, although almost all actions of the shoulder girdle or the scapula will cause some motion at this articulation. The unique double-hinged articular disk found at the junction of the clavicular head and

manubrium The sternum or breastbone is a long flat bone located in the central part of the chest. It connects to the ribs via cartilage and forms the front of the rib cage, thus helping to protect the heart, lungs, and major blood vessels from injury. Sha ...

allows for movement between the clavicle and the disk during elevation and depression of the scapula. This disk also allows motion between the sternum (manubrium) and itself during

protraction Motion, the process of movement, is described using specific anatomical terms. Motion includes movement of organs, joints, limbs, and specific sections of the body. The terminology used describes this motion according to its direction relative ...

and retraction of the scapula.

Clinical significance

Dislocation

Sternoclavicular dislocation is rare, but may result from direct trauma to the clavicle or indirect forces applied to the shoulder. Posterior dislocations deserve special attention, as they have the potential to be life-threatening because of the risk of damage to vital structures in the

mediastinum The mediastinum (from ) is the central compartment of the thoracic cavity. Surrounded by loose connective tissue, it is an undelineated region that contains a group of structures within the thorax, namely the heart and its vessels, the esophagu ...

; surgery can be used to fix such dislocations, as they are unlikely to heal by themselves. A spontaneous

partial dislocation In materials science, a partial dislocation is a decomposed form of dislocation that occurs within a crystalline material. An ''extended dislocation'' is a dislocation that has dissociated into a pair of partial dislocations. The vector sum of t ...

mayalso sometimes occur.

Other

SAPHO syndrome SAPHO syndrome includes a variety of inflammatory bone disorders that may be associated with skin changes. These diseases share some clinical, radiologic, and pathologic characteristics. An entity initially known as chronic recurrent multifocal ...

there may be

arthropathy An arthropathy is a disease of a joint. Types Arthritis is a form of arthropathy that involves inflammation of one or more joints, while the term arthropathy may be used regardless of whether there is inflammation or not. Joint diseases can be cla ...

of the sternoclavicular joint.

Septic arthritis Acute septic arthritis, infectious arthritis, suppurative arthritis, osteomyelitis, or joint infection is the invasion of a joint by an infectious agent resulting in joint inflammation. Generally speaking, symptoms typically include redness, hea ...

may rarely affect the sternoclavicular joint.

References

External links

Overview at ouhsc.edu
* {{Authority control Joints Thorax (human anatomy)