Clinical evaluation of injuries to the acromioclavicular and sternoclavicular joints.

Acromioclavicular injuries are common and most often can be accurately diagnosed using history, physical examination, and routine radiography. Sternoclavicular subluxations and dislocations may also be accurately characterized with only history, physical examination, and routine radiography (i.e., serendipity view). In many cases of sternoclavicular dislocation, however--especially posterior--CT scanning or MR imaging will be necessary. Posterior sternoclavicular dislocation may cause compression of mediastinal structures. When this is suspected, angiography or CT angiography is indicated. Physeal injuries should be suspected at either end of the clavicle in adolescent patients.