Thanks very much to everyone who shared their thoughts. Below are the responses. The majority is in favor of periosteal stripping/sleeve avulsion as a result of the initial dislocation:
Zaid
-I wonder, although he’s not a kid, the injury in his case had a pattern of periosteal sleeve avulsion, similar to what we see in distal clavicle in children with AC separation. He’s young and could have left periosteal sleeve behind when dislocated proximal clavicle, now it’s mineralizing. I would follow up with CT to make sure it’s maturing.
-Leave it be.
We often see capsular periosteal stripping at the clavicular insertion.
It’s just post traumatic ossification, will likely remodel.
MR might just cause confusion with the post traumatic edema.
-It would be no surprise that joint capsule and connected periosteum would be stripped at the time of dislocation.
More likely to happen in children and young adults.
I am not concerned by the appearance and would not investigate further.
-Agree, looks like it’s related to periosteal elevation from the trauma.
-Great case immature skeleton with periosteal sleeve avulsion of the head of medial clavicle OC ,looks reduced but mri evaluation would be confirmation. Although not sure surgery has anything to offer if slightly offset from my experience in the presence of the alignment natural adaptation thru. monitoring rehab.
-this is some periosteal stripping which took place at the time of trauma and is now healing like this. No real additional significance.
-I’d worry about infection after the dislocation but it may have subsided in the interim
On Mar 23, 2025, at 4:28 PM, zaid wrote:
Hi
I would appreciate your views on this CT. 20 year old athlete 5 week post closed reduction of right sternoclavicular joint dislocation. CT shows "sheet like" mineralization along the right proximal clavicle. Presumably this represents some form of post-traumatic periosteal reaction. Its just that the pattern seems little unusual to me and want to check if anyone has other thoughts. I wonder if MRI will have added value here. The SC joints are congruent.
Thanks
Zaid
