Spontaneous dislocation of the sterno-clavicular joint.

A description is given of 22 patients, with a spontaneous forward subluxation of the sternal end of the clavicle, seen over a 5-year period. The majority were middle-aged women presenting with a lump at the root of the neck, which was usually associated with little or no discomfort. There was no history of injury and no interference with shoulder function. The diagnosis was obvious on clinical examination and no treatment was required other than explanation, reassurance and simple analgesia. In no case was the correct diagnosis made by the referring physician and many of the patients were unduly concerned by the nature of the swelling. The sterno-clavicular joint is a synovial articulation and consequently it may be involved in rheumati arthropathy. A condition of non-infective subacute arthritis of the sterno-clavicular joint has been described and is similar to that reported here but in contrast to the previous report we believe that the changes which occur in the joint are secondary to its subluxation.