This is a simple case of persistent pain felt in the right sternoclavicular joint and clavicle region with somatic referred pain into the right trtrapezius and scapular region. These may be missed if the trapezius and scapular pain are dominant. The standard active, passive and isometric resisted shoulder tests are sufficient to identify the problem, but some additional tests that target the clavicular joints, plus tenderness on the STC Joint line helps to confirm the clinical diagnosis. The special orthopaedic tests for rotator cuff lesions are unnecessary and usually confuse the picture. In most cases the STC joint is visibly swollen. The treatment of choice is intra-articular corticosteroid injection. This rarely fails to rapidly abolish the pain, and only occasionally is a second injection required. Movement therapies are routinely unsuccessful, often aggravating the pain.
Posted by Dr Mark Laslett on Monday, September 17, 2018