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Clavicle Injuries
Arthur B. Meyers, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Diagnostic Checklist

          TERMINOLOGY

          • Synonyms

            • Distal clavicular periosteal sleeve fracture = Salter-Harris (SH) fracture of distal/lateral clavicle
            • Medial clavicle epiphyseal/physeal fracture: Pseudodislocation of sternoclavicular joint (SC)
          • Definitions

            • Occur at midshaft or at medial or lateral ends
            • Growth plates & epiphyses are present at medial & lateral ends of clavicle
              • 2° ossification centers do not appear until 2nd decade of life & often do not fuse until 3rd decade
              • Displaced fractures through unossified cartilage mimic acromioclavicular (AC) & sternoclavicular (SC) joint dislocations

          IMAGING

          • General Features

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  • Ultrasonographic Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • Staging, Grading, & Classification

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              • Treatment

                                DIAGNOSTIC CHECKLIST

                                • Consider

                                  • Image Interpretation Pearls

                                    Selected References

                                    1. Flores DV et al: Imaging of the acromioclavicular joint: anatomy, function, pathologic features, and treatment. Radiographics. 40(5):1355-82, 2020
                                    2. Zember J et al: Normal development imaging pitfalls and injuries in the pediatric shoulder. Pediatr Radiol. 49(12):1617-28, 2019
                                    3. Fadell M et al: Radiological features of healing in newborn clavicular fractures. Eur Radiol. 27(5):2180-7, 2017
                                    4. Beckmann N et al: Posterior sternoclavicular Salter-Harris fracture-dislocation in a patient with unossified medial clavicle epiphysis. Skeletal Radiol. 45(8):1123-7, 2016
                                    5. Moyer JE et al: Shoulder injuries in pediatric athletes. Orthop Clin North Am. 47(4):749-62, 2016
                                    6. Lee JT et al: Posterior sternoclavicular joint injuries in skeletally immature patients. J Pediatr Orthop. 34(4):369-75, 2014
                                    7. Walker BM et al: Congenital pseudoarthrosis of the clavicle: a diagnostic challenge. Glob Pediatr Health. 1:2333794X14563384, 2014
                                    8. Van Tongel A et al: Sternoclavicular joint injuries: a literature review. Muscles Ligaments Tendons J. 1(3):100-5, 2011
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Terminology

                                      • Imaging

                                        • Top Differential Diagnoses

                                          • Diagnostic Checklist

                                            TERMINOLOGY

                                            • Synonyms

                                              • Distal clavicular periosteal sleeve fracture = Salter-Harris (SH) fracture of distal/lateral clavicle
                                              • Medial clavicle epiphyseal/physeal fracture: Pseudodislocation of sternoclavicular joint (SC)
                                            • Definitions

                                              • Occur at midshaft or at medial or lateral ends
                                              • Growth plates & epiphyses are present at medial & lateral ends of clavicle
                                                • 2° ossification centers do not appear until 2nd decade of life & often do not fuse until 3rd decade
                                                • Displaced fractures through unossified cartilage mimic acromioclavicular (AC) & sternoclavicular (SC) joint dislocations

                                            IMAGING

                                            • General Features

                                              • Radiographic Findings

                                                • CT Findings

                                                  • MR Findings

                                                    • Ultrasonographic Findings

                                                      • Imaging Recommendations

                                                        DIFFERENTIAL DIAGNOSIS

                                                          PATHOLOGY

                                                          • Staging, Grading, & Classification

                                                            CLINICAL ISSUES

                                                            • Presentation

                                                              • Demographics

                                                                • Treatment

                                                                  DIAGNOSTIC CHECKLIST

                                                                  • Consider

                                                                    • Image Interpretation Pearls

                                                                      Selected References

                                                                      1. Flores DV et al: Imaging of the acromioclavicular joint: anatomy, function, pathologic features, and treatment. Radiographics. 40(5):1355-82, 2020
                                                                      2. Zember J et al: Normal development imaging pitfalls and injuries in the pediatric shoulder. Pediatr Radiol. 49(12):1617-28, 2019
                                                                      3. Fadell M et al: Radiological features of healing in newborn clavicular fractures. Eur Radiol. 27(5):2180-7, 2017
                                                                      4. Beckmann N et al: Posterior sternoclavicular Salter-Harris fracture-dislocation in a patient with unossified medial clavicle epiphysis. Skeletal Radiol. 45(8):1123-7, 2016
                                                                      5. Moyer JE et al: Shoulder injuries in pediatric athletes. Orthop Clin North Am. 47(4):749-62, 2016
                                                                      6. Lee JT et al: Posterior sternoclavicular joint injuries in skeletally immature patients. J Pediatr Orthop. 34(4):369-75, 2014
                                                                      7. Walker BM et al: Congenital pseudoarthrosis of the clavicle: a diagnostic challenge. Glob Pediatr Health. 1:2333794X14563384, 2014
                                                                      8. Van Tongel A et al: Sternoclavicular joint injuries: a literature review. Muscles Ligaments Tendons J. 1(3):100-5, 2011