SC joint arthrosis

Sternoclavicular joint osteoarthritis (COX osteoarthritis) – causes, symptoms and treatment options

Sternoclavicular joint arthrosis is a rare but significant degenerative disease of the sternoclavicular joint (SCJ), which connects the shoulder girdle to the sternum. Although osteoarthritis is less common in this area than in larger joints such as the knee or hip, it can cause significant pain and disability. The disease is particularly common in older people, with the first signs often observed after age 50. Studies show that almost all people over 60 have radiological evidence of degenerative changes in the SCJ, although these changes are not always symptomatic.

The SCJ is a small synovial joint that allows for a wide range of motion in the shoulder girdle. It is stabilized by strong ligaments and features a joint disc that acts as a shock absorber between the bones. With increasing age or chronic overload, the cartilage in the joint can wear out, leading to the development of osteoarthritis. Common causes include age-related wear and tear, repetitive stress, such as that encountered during strenuous physical labor or certain sports, as well as injuries such as fractures or dislocations of the clavicle. Rheumatoid arthritis and other inflammatory diseases can also promote the development of osteoarthritis.

Die Symptome der SCG-Arthrose variieren je nach Schweregrad der Erkrankung. Typisch sind Schmerzen im Bereich des Gelenks, die bei Belastung oder Druck auf das Gelenk zunehmen. Häufig strahlen die Schmerzen in die Schulter oder den oberen Brustkorb aus. Bewegungseinschränkungen, insbesondere bei Überkopfarbeiten, sind ebenso häufig wie ein fühlbares oder hörbares Knirschen (Krepitation) während der Bewegung. In fortgeschrittenen Stadien kann das Gelenk geschwollen sein und sichtbare Deformitäten aufweisen.

The diagnosis of SCJ osteoarthritis is made through a thorough clinical examination and imaging. X-rays typically show narrowing of the joint space, osteophytes (bone growths), and sclerosis. In unclear cases or when additional inflammatory processes are suspected, an MRI may be helpful.

Treatment for SCJ osteoarthritis depends on the severity of the symptoms and usually begins conservatively. Pain medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) and local cortisone injections are often used to reduce pain and inflammation. Physical therapy can help improve mobility and strengthen muscles. Severe osteoarthritis or persistent symptoms may require surgery. A common procedure is resection of the medial end of the clavicle to reduce pain and improve function. Other surgical options include joint debridement or ligament reconstruction, especially when instability is present.

Although SCJ osteoarthritis is relatively rare, it should be considered in patients with chronic shoulder or chest pain. Early diagnosis and treatment can help relieve symptoms and improve quality of life.