X-ray-negative posterior sternoclavicular dislocation after minor trauma.

Area of Science:

• Orthopedic Surgery
• Emergency Medicine
• Radiology

Background:

• Posterior sternoclavicular dislocation is an uncommon injury.
• It poses diagnostic challenges due to subtle physical findings and plain radiography limitations.
• Prompt recognition is vital to avoid significant vascular complications.

Observation:

• A case of a 19-year-old male with isolated posterior sternoclavicular dislocation following minor blunt trauma is presented.
• Diagnosis was delayed, requiring multiple imaging modalities across two emergency department visits.
• The injury was ultimately diagnosed and managed with intraoperative reduction.

Findings:

• Posterior sternoclavicular dislocations can be easily missed on initial examination and standard X-rays.
• Multiple imaging modalities may be necessary for accurate diagnosis.
• Intraoperative reduction is a successful management strategy.

Implications:

• Emergency physicians must maintain a high index of suspicion for posterior sternoclavicular dislocations.
• Early and accurate diagnosis is essential to prevent potentially life-threatening vascular compromise.
• Advanced imaging and surgical intervention may be required for optimal patient outcomes.