Articulatio sternoclavicularis

The sternoclavicular joint is a synovial joint between the medial clavicle, manubrium and the first costal cartilage that joins the upper limb with the axial skeleton.

Gross anatomy

There are two non-congruent articular surfaces forming a saddle joint :

  • medial clavicle: larger of the two
  • clavicular notch of the sternum: smaller of the two

The articular surfaces are covered with fibrocartilage (rather than hyaline cartilage as in most other synovial joints). The joint space is divided into two separate recesses by a fibrocartilage articular disc .

Ligaments

Due to the non-congruent articular facets, much of the joint stability comes from surrounding ligaments :

  • anterior and posterior sternoclavicular ligament: thickenings of the joint capsule
  • interclavicular ligament: between the superomedial ends of the clavicles
  • costoclavicular ligament
Special structures
  • articular disc 
    • flat and oval in shape
    • made of fibrocartilage (like the menisci of the knee and labrum of the hip and shoulder)
    • attached to the joint capsule anteriorly and posteriorly, first costal cartilage inferiorly and the clavicle superiorly
Relations

Blood supply

Innervation

  • medial supraclavicular and subclavian nerves

Variant anatomy

  • ~2.5% of the population have an inferior facet for articulation with the first rib
  • perforation of the articular disc, where the joint recesses are in communication

Related pathology

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