Department of Trauma and Orthopaedics, Addenbrooke's Hospital, Cambridge University Hospitals, Hills Road, Cambridge, CB2 0QQ, UK.
Skeletal Radiol. 2013 Apr;42(4):473-8. doi: 10.1007/s00256-012-1502-6. Epub 2012 Aug 30.
To describe the plane of the sternoclavicular joint (SCJ) to aid planning of instrument orientation during invasive procedures.
Computed tomography (CT) images of 80 consecutive patients aged 25 to 40 years with appropriate chest imaging series were retrospectively reviewed. Patients with a previous median sternotomy, fused manubriosternal joint or fracture were excluded. The medial clavicle was found to vary greatly in its anatomy such that a representative morphology could not be described. The manubrium was found to be a more consistent structure and was examined in more detail. The angulation of the SCJ was measured in three orthogonal planes using CT multiplanar reformats. Each SCJ (160 in total) was assessed for transverse, coronal, and sagittal angulation of the central manubrial articular surface in respect to the long axis of the manubrial body using a newly devised measurement technique.
The mean angles (± standard deviation) of the SCJs were 62.4 ± 9.7° to the transverse plane, 149.3 ± 7.3° to the coronal plane and 69.8 ± 7.5 to the sagittal plane. There was no significant difference in transverse (p = 0.41) or sagittal (p = 0.60) angulation between sides, however there was a significant difference for the coronal plane (p = 0.04). No significant differences were noted between the sexes in any plane.
Increasing use of invasive diagnostic and treatment techniques dictate that a safe approach to the joint should be used to reduce the risk of iatrogenic injury. This study adds to existing knowledge of SCJ anatomy and its variation within the population. Understanding this can minimize the risk to adjacent structures when approaching the SCJ with injection needles or arthroscopic instruments.
描述胸锁关节（SCJ）的平面，以帮助在有创性操作中规划器械方向。
回顾性分析了 80 例年龄在 25 岁至 40 岁的连续患者的 CT 图像，这些患者均具有适当的胸部成像系列。排除了先前有正中胸骨切开术、胸锁关节融合或骨折的患者。发现锁骨内侧的解剖结构差异很大，无法描述代表性形态。胸骨被认为是一种更一致的结构，并进行了更详细的检查。使用 CT 多平面重建，在三个正交平面上测量 SCJ 的角度。使用新设计的测量技术，总共评估了 160 个 SCJ，以评估中央胸骨关节面相对于胸骨体长轴的冠状、矢状和横断角度。
SCJ 的平均角度（平均值±标准差）分别为 62.4°±9.7°至横平面、149.3°±7.3°至冠状平面和 69.8°±7.5°至矢状平面。两侧的横断（p=0.41）或矢状（p=0.60）角度无显著差异，但冠状平面有显著差异（p=0.04）。任何平面的性别之间均无显著差异。
越来越多的侵袭性诊断和治疗技术的应用要求采用安全的方法来接近关节，以降低医源性损伤的风险。本研究增加了对 SCJ 解剖结构及其在人群中的变异性的现有认识。了解这一点可以在使用注射针或关节镜器械接近 SCJ 时，最大限度地降低对相邻结构的风险。
