Abbreviations: AC = Acromioclavicular, SC = Sternoclavicular
Without adequate references, it is difficult to determine the rationale for the importance apportioned to palpating these two structures (the suprasternal angle and SC joint) following an AC joint injury. Nevertheless, a year 2000 article; Acromioclavicular joint injuries by Beim G. M. (MD) and published in the Journal of Athletic Training recommends the following when evaluating an AC joint injury:
“The physical examination should begin with careful observation of the patient’s shoulder without any obstruction from clothing or improper gowning. Inspect the shoulder contour with the patient in the seated position in order to accentuate any deformity that may be present at the AC joint. View the shoulder from both superior and anterior positions in order to note any subtle anteroposterior displacements of the AC joint. Carefully palpate the sternoclavicular joint, clavicle, and AC joint to appreciate any subtle deformities and to elicit focal areas of tenderness. In addition, palpate for soft tissue defects. If there is obvious subluxation or dislocation of the AC joint, attempt a gentle reduction by supporting the ipsilateral arm and depressing the distal clavicle in order to establish the type of AC injury. Finally, identify and record the neurovascular status of the extremity.”
Following from the above, it is likely the examination of the suprasternal angle is to rule out any collateral soft tissue injuries to blood vessels or nerves as a result of a possible bony displacement following the AC joint injury. Palpating the SC joint may reveal subtle deformities and areas of focal tenderness.
You can read Dr. Beim’s entire article here.
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