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# SC capsule

The sternoclavicular capsule seals the joint between the collarbone and the breastbone; its back part is the strongest.

Official name: Sternoclavicular joint capsule

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## What it is

The capsule around the joint between the collarbone and the breastbone.

## What it does

Seals the joint; its back part is the strongest.

## Key points

- Posterior SC dislocation is the dangerous one: the medial [clavicle](https://durgical.com/en/anatomy/clavicle/) can press on the trachea, oesophagus and great vessels behind it; CT is needed
- The posterior part of the capsule is the main restraint to both forward and backward displacement of the medial clavicle
- In people under about 25, an apparent SC dislocation is often a fracture through the medial clavicular growth plate

## Key facts

**Attaches**
Medial end of the clavicle to the [manubrium](https://durgical.com/en/anatomy/manubrium-of-sternum/) and 1st [costal cartilage](https://durgical.com/en/anatomy/costal-cartilage/)

**Function**
Strong; with the [sternoclavicular ligaments](https://durgical.com/en/anatomy/sternoclavicular-ligaments/) it is the only bony link between the arm and the trunk

## Relations

**Contents**
[SC disc](https://durgical.com/en/anatomy/sternoclavicular-joint-disc/), which splits the joint into two cavities

**In front**
Clavicular and sternal heads of the [sternocleidomastoid](https://durgical.com/en/anatomy/sternocleidomastoid-muscle/) and the [pectoralis major](https://durgical.com/en/anatomy/pectoralis-major-muscle/) origin; [skin](https://durgical.com/en/anatomy/skin/)

**Behind**
[Sternohyoid](https://durgical.com/en/anatomy/sternohyoid-muscle/) and [sternothyroid](https://durgical.com/en/anatomy/sternothyroid-muscle/); then the [brachiocephalic vein](https://durgical.com/en/anatomy/brachiocephalic-vein/), the [common carotid artery](https://durgical.com/en/anatomy/common-carotid-artery/) (on the right the [brachiocephalic trunk](https://durgical.com/en/anatomy/brachiocephalic-trunk/)), [trachea](https://durgical.com/en/anatomy/trachea/) and oesophagus

**Below**
[Costoclavicular ligament](https://durgical.com/en/anatomy/costoclavicular-ligament/) from the [first rib](https://durgical.com/en/anatomy/first-rib/), the pivot of clavicular movement

**Above**
[Interclavicular ligament](https://durgical.com/en/anatomy/interclavicular-ligament/) across the jugular notch

## How to find it

The medial ends of both clavicles are felt on either side of the jugular (suprasternal) notch; when the shoulders shrug up and down the joint moves under the finger, the clavicle end dipping as the shoulder rises.

## On imaging

Plain films are hard to read; the serendipity view (beam tilted about 40° upward) compares both sides. CT is the study of choice, showing the direction of displacement and the structures behind the joint.

## Clinical notes

- Posterior dislocation can cause hoarseness, difficulty swallowing, breathlessness or venous congestion of the arm; closed or open reduction is done with a thoracic surgeon available
- Septic arthritis of the SC joint is classically seen with injected drug use, diabetes or central venous lines
- Anterior dislocation is more common; it often stays unstable but usually causes little disability

## Development

The medial clavicular epiphysis appears in the late teens and fuses in the early to mid-20s, the last growth plate in the body to close.

## Test yourself

Think of the answer, then tap the question to see it.

## Why is a posterior dislocation through the SC capsule dangerous?

The medial clavicle can press on the trachea, oesophagus and great vessels behind it; CT is needed.

## Which part of the SC capsule is the main restraint of the medial clavicle?

The posterior part, against both forward and backward displacement.

## In people under about 25, what is an apparent SC dislocation often?

A fracture through the medial clavicular growth plate.

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Educational information, not medical advice. For any symptom, see a health professional.

## Its names

**Official Latin (TA2)**
capsula articularis articulationis sternoclavicularis TA2 1536

**Official Spanish (DeCS)**
Cápsula articular de la articulación esternoclavicular

**English (TA2)**
Sternoclavicular joint capsule

## Related

- [SC ligaments](https://durgical.com/en/anatomy/sternoclavicular-ligaments/)
- [Clavicle](https://durgical.com/en/anatomy/clavicle/)
- [Manubrium](https://durgical.com/en/anatomy/manubrium-of-sternum/)

Sources: Terminologia Anatomica (TA2); [Anatomy, Shoulder and Upper Limb, Sternoclavicular Joint](https://www.ncbi.nlm.nih.gov/books/NBK537258/).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/anatomy/sternoclavicular-joint-capsule/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/sternoclavicular-joint-capsule/