Sonographically guided sternoclavicular joint injection: description of technique and validation

Area of Science:

• Musculoskeletal Imaging
• Interventional Radiology
• Anatomy

Background:

• The sternoclavicular joint (SCJ) is a complex articulation prone to pain syndromes.
• Accurate joint injection is crucial for diagnosis and treatment of SCJ conditions.
• Sonographic guidance offers a precise method for joint injections.

Purpose of the Study:

• To describe and validate a sonographically guided injection technique for the SCJ.
• To assess the accuracy and safety of this technique in a cadaveric model.

Main Methods:

• A single operator performed 13 sonographically guided SCJ injections on 7 unembalmed cadavers.
• An out-of-plane, caudad-to-cephalad approach was used to inject 1 mL of blue latex.
• Cadaveric dissection was performed to evaluate injectate location and identify complications.

Main Results:

• All 13 injections (100% accuracy) successfully placed latex within the SCJ.
• The injectate showed a predilection for the clavicular side (77% predominantly clavicular, 23% equally distributed).
• No instances of neurovascular injury or extracapsular flow were observed.

Conclusions:

• Sonographically guided SCJ injections are feasible and accurate, with a tendency to target the clavicular portion.
• This technique can aid in diagnosing and managing medial shoulder pain.
• Consideration for sternal-side targeting or confirmation of flow is advised in specific patient populations.