Vadgaonkar Aditya, Darwich Ali, Gravius Sascha, Hackl Michael, Rink Johann, Janssen Sonja, Baumgärtner Tobias, Obertacke Udo
Department of Orthopaedic and Trauma Surgery, University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Department of Radiology and Nuclear Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Arch Orthop Trauma Surg. 2025 Jun 30;145(1):359. doi: 10.1007/s00402-025-05967-w.
Osteoarthritis (OA) is the most prevalent disorder of the Sternoclavicular Joint (SCJ), with a reported lifetime prevalence of approximately 50%, yet it is rarely observed in individuals under the age of 35. When symptomatic, it manifests with pain and swelling. Although OA is strongly age-related, the influence of biomechanical factors - such as clavicular length - remains unknown.
In this retrospective case-control study, computed tomography (CT) scans of adult polytrauma patients admitted to our hospital between 2012 and 2014 were evaluated. OA was defined radiologically by the presence of osteophytes, subchondral cysts, or cortical sclerosis, and a score from 0 to 6 was assigned according to the severity of these changes. Medial-most and lateral-most points of the clavicle were used to determine clavicular length. The x-, y-, and z-coordinates of these two points were extracted from the DICOM metadata and clavicular length was calculated as the distance between these two points using 3D geometry.
A total of 334 SCJs from 167 patients (36% female, mean age 48.5 ± 20.5 years) were analyzed. Mean clavicular length was shorter in the group with OA (144 ± 11 mm vs. 150 ± 12 mm, < 0.001, right; 146 ± 11 mm vs. 153 ± 11 mm, < 0.001, left). Age and clavicular length were independent risk factors on multivariate regression model. The logistic model showed a robust discriminative ability with the area under the curve being 90% (right) and 91% (left). Adjusted odds ratios were 0.93 (right) and 0.92 (left). Mean clavicular length showed a decreasing trend with increasing OA scores ( = 0.01).
Our findings suggest that shorter clavicles are associated with a higher prevalence of sternoclavicular joint osteoarthritis, demonstrating an inverse correlation between clavicular length and the severity of the radiological signs of degeneration. Prospective studies are warranted to further investigate the clinical implications of clavicular shortening and its potential role in the development of SCJ osteoarthritis.
骨关节炎（OA）是胸锁关节（SCJ）最常见的疾病，据报道终生患病率约为50%，但在35岁以下人群中很少见。出现症状时，表现为疼痛和肿胀。虽然OA与年龄密切相关，但生物力学因素（如锁骨长度）的影响尚不清楚。
在这项回顾性病例对照研究中，对2012年至2014年期间我院收治的成年多发伤患者的计算机断层扫描（CT）图像进行了评估。根据是否存在骨赘、软骨下囊肿或皮质硬化在影像学上定义OA，并根据这些变化的严重程度给予0至6分。使用锁骨最内侧和最外侧点来确定锁骨长度。从DICOM元数据中提取这两个点的x、y和z坐标，并使用三维几何计算这两个点之间的距离作为锁骨长度。
共分析了167例患者的334个胸锁关节（女性占36%，平均年龄48.5±20.5岁）。OA组的平均锁骨长度较短（右侧：144±11mm对150±12mm，<0.001；左侧：146±11mm对153±11mm，<0.001）。在多变量回归模型中，年龄和锁骨长度是独立的危险因素。逻辑模型显示出较强的判别能力，曲线下面积右侧为90%，左侧为91%。校正后的比值比右侧为0.93，左侧为0.92。平均锁骨长度随OA评分增加呈下降趋势（P=0.01）。
我们的研究结果表明，较短的锁骨与胸锁关节骨关节炎的较高患病率相关，表明锁骨长度与放射学退变征象的严重程度呈负相关。有必要进行前瞻性研究，以进一步探讨锁骨缩短的临床意义及其在胸锁关节骨关节炎发展中的潜在作用。
