Sternoclavicular Joint Injection

Acute or chronic capsulitis

Causes and findings:
• Trauma, overuse in the degenerate shoulder or occasionally rheumatoid arthritis
• Pain over sternoclavicular joint
• Painful: retraction and protraction of the shoulder full elevation of the arm clicking or subluxation after trauma

Equipment:
Syringe - 1ml
Needle - 25G 0.5 inches (16mm) orange
Kenalog 40 - 10 mg
Lidocaine - 0.5 ml 2%
Total volume - 0.75 ml

Anatomy:
The sternoclavicular joint contains a small meniscus that can sometimes be damaged and then give painful symptoms. The joint line runs obliquely laterally
from superior to inferior and can be identified by palpating the joint medial to the end of the clavicle while the patient protracts and retracts the shoulder.

Technique
• Patient sits supported with arm in slight lateral rotation
• Identify mid-point of joint line
• Insert needle perpendicularly through joint capsule
• Inject solution as a bolus

Aftercare:
Rest for a week followed by mobilization and a progressive postural and exercise regime. Taping the joint helps stabilize it in the acute stage after trauma.

Comments:
Although not a common lesion, this usually responds well to one infiltration.