Dislocations: posterior sternoclavicular dislocation: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Dislocations: posterior sternoclavicular dislocation

Sample item

A man in a rugby scrum has pain over the sternoclavicular joint, difficulty swallowing and a hoarse voice after a blow to the shoulder. What is the likely injury and its significance?

AIsolated rib fracture with no major riskBAcromioclavicular sprain needing sling onlyCPosterior sternoclavicular dislocation with mediastinal compression, needing urgent reductionDAnterior sternoclavicular dislocation, which is always an emergency

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Posterior sternoclavicular dislocation with mediastinal compression, needing urgent reduction

In posterior sternoclavicular dislocation the medial clavicle displaces behind the sternum and may compress the trachea, oesophagus or great vessels. It needs CT imaging and reduction in a setting where thoracic surgery backup is available.

Option by option

A. Isolated rib fracture with no major risk
Simple rib fracture does not explain dysphagia and hoarseness.
B. Acromioclavicular sprain needing sling only
An ACJ sprain does not cause these symptoms.
C. Posterior sternoclavicular dislocation with mediastinal compression, needing urgent reduction (correct)
Correct. Dysphagia and hoarseness suggest posterior displacement compressing mediastinal structures.
D. Anterior sternoclavicular dislocation, which is always an emergency
Anterior dislocation is usually benign and treated conservatively.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is C, Posterior sternoclavicular dislocation with mediastinal compression, needing urgent reduction. In posterior sternoclavicular dislocation the medial clavicle displaces behind the sternum and may compress the trachea, oesophagus or great vessels.

Why is "Isolated rib fracture with no major risk" not the answer?

Simple rib fracture does not explain dysphagia and hoarseness.

Why is "Acromioclavicular sprain needing sling only" not the answer?

An ACJ sprain does not cause these symptoms.

Why is "Anterior sternoclavicular dislocation, which is always an emergency" not the answer?

Anterior dislocation is usually benign and treated conservatively.

What concept does this question test?

It tests Dislocations: posterior sternoclavicular dislocation in Orthopaedics. It needs CT imaging and reduction in a setting where thoracic surgery backup is available.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Dislocations: posterior sternoclavicular dislocation?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.