Introduction
Sterno-Costo-Clavicular Hyperostosis (SCCH) is a rare, chronic inflammatory bone disorder affecting the upper anterior chest wall. It primarily involves the sternum, clavicles, and upper ribs, leading to pain, stiffness, and progressive functional limitation. Early diagnosis and physiotherapy play a crucial role in symptom control and maintaining mobility.
Definition
Sterno-Costo-Clavicular Hyperostosis is a benign, non-infectious condition characterized by excessive bone formation (hyperostosis) and chronic inflammation at the sternoclavicular joints, clavicles, and adjacent ribs.
Clinical Features
- Gradual onset of pain over the sternoclavicular region
- Swelling and tenderness around the clavicle and upper chest
- Morning stiffness worsening with activity
- Restricted shoulder and neck movements
- Local warmth or redness in active inflammatory stages
- Postural abnormalities due to pain avoidance
- Difficulty in overhead activities and lifting
Physiotherapy Management
Physiotherapy aims to reduce pain, improve mobility, and prevent functional decline:
- Pain-relief modalities such as hot packs or TENS
- Gentle range-of-motion exercises for the shoulder, neck, and thoracic spine
- Breathing exercises to maintain chest wall mobility
- Postural correction and ergonomic training
- Strengthening exercises for the shoulder girdle and scapular stabilizers
- Stretching of the pectoral and upper thoracic muscles
- Activity modification and joint protection techniques
- Home exercise program for long-term symptom control
Complications
- Progressive restriction of shoulder and chest wall movement
- Chronic pain and stiffness
- Reduced respiratory chest expansion
- Postural deformities such as rounded shoulders
- Functional limitations in daily activities
- Psychological stress due to chronic symptoms
- Rarely, ankylosis of the sternoclavicular joints
Risk Factors
- Middle-aged to older adults
- Female predominance
- Chronic inflammatory conditions
- History of autoimmune disorders
- Recurrent chest wall stress or microtrauma
- Genetic susceptibility
- Long-standing musculoskeletal inflammation
Conclusion
Sterno-Costo-Clavicular Hyperostosis is a chronic but manageable condition when identified early. Although no definitive cure exists, a multidisciplinary approach involving medical care and structured physiotherapy can remarkablyreduce symptoms, preserve joint mobility, and improve quality of life. Long-term rehabilitation remains essential for optimal functional outcomes.
Q1. What is Sterno-Costo-Clavicular Hyperostosis (SCCH)?
SCCH is a rare, benign inflammatory bone disorder causing excessive bone formation and chronic inflammation of the sternoclavicular joints, clavicles, and upper ribs.
Q2. What are the common clinical features of SCCH?
It presents with chest wall pain, swelling, morning stiffness, restricted shoulder and neck movement, postural changes, and difficulty with overhead activities
Q3. How does physiotherapy help in SCCH management?
Physiotherapy reduces pain, improves chest and shoulder mobility, corrects posture, enhances breathing capacity, and prevents long-term functional limitations.