Physio Edge podcast with David Pope

095. Sternoclavicular joint pain diagnosis, imaging & red flags with Jo Gibson


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The sternoclavicular joint (SCJ) can cause pain locally, or refer into the neck and shoulder. With a relatively high incidence of serious and potentially life-threatening pathology at the SCJ, it’s important to diagnose the source of SCJ pain. In this (Facebook live/video/podcast) with Jo Gibson (Clinical Specialist Physiotherapist), you’ll discover:

  • How to identify and diagnose the SCJ as the source of pain.
  • Where does the SCJ commonly refer pain to?
  • What pathologies cause SCJ pain
  • What activities & movements commonly reproduce pain in the SCJ?
  • Who develops SCJ pain?
  • Which differential diagnosis (DDx) are important to identify, including
    • localised osteoarthritis (OA)
    • rheumatoid arthritis
    • septic arthritis
    • atraumatic subluxation
    • seronegative spondyloarthropathies
    • gout, pseudogout
    • SC hyperostosis
    • condensing osteitis
    • Friedrich’s disease/avascular necrosis
    • condensing arthritis
    • Friedrich’s disease and
    • ‘SAPHO’ (Synovitis Acne Pustulosis Hyperostosis Osteitis) syndrome
  • How does DDx impact prognosis?
  • What role does imaging have with the SCJ?
  • SCJ Imaging - MRI vs CT vs Xray.
  • If pain refers down to the anterior chest, what other structures may be involved?
  • Tietze syndrome at the costochondral junction.
  • Costochondritis - who develops it, is there a mechanism of injury?
  • Red flags you need to be aware of around the SCJ
  • Case study of an SCJ patient where a potentially life-threatening illness was identified.
  • Other red flags - infection, HIV, septic arthritis, diabetes, ankylosing spondylitis, gout.
  • What investigations are important for SCJ pain patients?
  • What are realistic expectations for prognosis and resolution of SCJ symptoms?
  • How can you rehab patients with SCJ pain?
  • Costochondral joint pain.
  • Rehab following clavicular ORIF
  • When is arthroscopic release suitable in frozen shoulder patients
Podcast handout

Free video series “Frozen shoulder assessment & treatment” with Jo Gibson

Shoulder: Steps to Success online course with Jo Gibson

Improve your assessment and treatment of shoulder pain with the Shoulder: Steps to Success online course with Jo Gibson, now available for enrolment at clinicaledge.co/shouldersuccess

Links associated with this episode:
  • Get your access to the free video series “Frozen shoulder assessment & treatment” with Jo Gibson
  • Improve your shoulder assessment & treatment with the Shoulder: Steps to Success online course with Jo Gibson
  • Download and subscribe to the podcast on iTunes
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  • Improve your confidence and clinical reasoning with a free trial Clinical Edge membership
  • Let David know what you liked about this podcast on Twitter
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Physio Edge podcast with David PopeBy David Pope at Clinical Edge

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