A Fall To Remember - Page #1

Author: Shoaib Khalid, MD
Senior Editor: Marc Hilgers, MD, PhD, FAMSSM

Patient Presentation:
Left Sternoclavicular Joint Pain.

16 year old male, high school football running back, presents with pain near his left sternoclavicular (SC) joint for over 2 weeks. Initially he felt the shoulder pain after being tackled to the ground and falling on it laterally. He has persistent pain in his left SC joint and shoulder. He reports that whenever he abducts, forward flexes his arms above the shoulder level or whenever he reaches behind for an object, he feels a "choking" sensation. He cannot lift heavy objects because of the pain. He has no prior history of dislocations or instability. He denies radicular symptoms, chest pain, breathing difficulties, numbness or weakness.
Previous outside evaluations led to a working diagnosis of SC joint sprain

Physical Exam:
Healthy male in no acute distress. Visible swelling noted over the left sternoclavicular joint along with a palpable deformity and tenderness. Full shoulder range of motion but with any movement above the shoulder level a choking sensation recreated. He has 2+ distal pulses bilaterally and symmetrically palpated. Respirations are not labored and no audible stridor is appreciated. No sensory deficits noted as well.

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