The Onset of Sternoclavicular Joint Arthritis
While arthritis is often associated with older age, the degenerative process in the sternoclavicular (SC) joint, which connects the collarbone to the breastbone, starts much earlier for many people. Studies using computed tomography (CT) scans on asymptomatic individuals have provided valuable insights into the timeline of these changes. A landmark 2017 study found no signs of osteoarthritis (OA) in individuals younger than 35. However, the prevalence of these changes increased dramatically with age, indicating that the wear-and-tear process is a normal, if not inevitable, part of aging for this joint.
Asymptomatic vs. Symptomatic Degeneration
One of the most important distinctions to make is that the presence of arthritis on an imaging scan does not automatically mean a person will experience pain. Many people with age-related SCJ degeneration are completely asymptomatic. This is because the body is often able to compensate for the gradual wear and tear. Symptoms, when they do appear, are more common in older adults and can be triggered by specific activities or injuries.
What the Research Says About Age
Several studies have tracked the prevalence of SCJ arthritis across different age groups, providing a clear picture of its progression:
- Mid-30s and Younger: Radiographic signs are typically absent, suggesting this is when the joint is in its healthiest state from a degenerative perspective.
- Mid-30s to 50s: This is the period when early signs of degeneration, such as osteophytes (bone spurs) and subchondral cysts, begin to appear. Studies have shown these changes present from age 35 and increase in prevalence and severity with age.
- Over 50: Prevalence rises sharply. One study found that nearly 90% of patients older than 50 had some signs of OA on a CT scan.
- Over 60: Degenerative changes become extremely common. Cadaveric examinations show degenerative changes in virtually all specimens over the age of 50, and radiographic studies confirm high prevalence rates in this age group.
- Over 70: The severity of arthritis generally increases with age, with one study noting that 89% of patients over 70 had severe signs of OA in at least one joint.
Factors Contributing to SCJ Arthritis
While age is the most significant factor, it's not the only one. The following can accelerate or increase the risk of developing symptomatic SCJ arthritis:
- Biomechanics and Joint Stress: The SCJ is a weight-bearing joint that connects the upper limb to the rest of the body. Repetitive motions, manual labor, and physical activity can increase stress on the joint over time.
- Trauma: Previous injuries, such as a dislocation or fracture of the collarbone, can lead to post-traumatic arthritis in the SCJ later in life.
- Genetics: A family history of osteoarthritis may increase your susceptibility.
- Gender: Some conditions that affect the SCJ, such as condensing osteitis, are more common in women, though overall SCJ arthritis rates appear similar across genders.
- Other Inflammatory Conditions: Less common forms of arthritis, such as rheumatoid arthritis or SAPHO syndrome, can also affect the SCJ at any age.
Signs and Symptoms to Watch For
Recognizing the symptoms of symptomatic SCJ arthritis is crucial for seeking appropriate care. While the condition can be silent for decades, here are some common signs:
- Pain: A dull ache or sharp pain, often localized over the SCJ, particularly with movement of the arm across the body or with overhead lifting.
- Swelling: Noticeable swelling or a prominent bump over the joint area.
- Stiffness: A feeling of stiffness, especially in the morning or after periods of inactivity.
- Clicking or Grinding: An audible or palpable clicking, grinding, or popping sensation with shoulder movement (crepitus).
- Decreased Range of Motion: Difficulty with certain movements, particularly those involving the shoulder and arm.
Diagnosis and Treatment Options
Diagnosing symptomatic SCJ arthritis involves a physical examination and may be supported by imaging. The initial approach to treatment is typically conservative.
Conservative Treatment
- Rest and Activity Modification: Avoiding activities that aggravate the joint pain.
- Medications: Non-steroidal anti-inflammatory drugs (NSAIDs) can help manage pain and inflammation.
- Physical Therapy: Specific exercises to improve range of motion and strengthen surrounding muscles.
- Corticosteroid Injections: Injecting corticosteroids into the joint can provide temporary relief from pain and inflammation.
Comparison of SCJ Arthritis with Other Conditions
To properly diagnose SCJ pain, a physician must differentiate it from other issues that can cause similar symptoms. Here is a brief comparison:
| Feature | SCJ Arthritis | Costochondritis | Rheumatoid Arthritis (RA) |
|---|---|---|---|
| Cause | Cartilage degeneration from wear and tear, age, or trauma. | Inflammation of cartilage connecting ribs to breastbone. | Autoimmune disease causing systemic joint inflammation. |
| Location | Sternoclavicular joint (collarbone meets breastbone). | Multiple costochondral joints (ribs meet cartilage). | Can affect many joints symmetrically, including SCJ. |
| Symptom Profile | Aching, pain with specific arm movements, swelling, prominent bump. | Sharp, stabbing chest pain, often worse with deep breaths or coughing. | Joint swelling, pain, stiffness, fatigue. Usually symmetric. |
| Age of Onset | Typically begins after 35, symptomatic cases often older adults. | More common in older adults, but can affect all ages. | Usually develops between 30 and 60. |
When to See a Doctor
If you experience persistent pain, swelling, or stiffness in the area where your collarbone meets your chest, it is important to see a healthcare provider. While SCJ arthritis is common and often benign, a proper diagnosis is necessary to rule out other potential causes and to develop an effective management plan. A physician can help determine if your symptoms are related to the natural aging process or another underlying issue, and guide you toward appropriate treatment. For more detailed information on joint health, you can visit the American Academy of Orthopaedic Surgeons website at https://orthoinfo.aaos.org. Getting a professional evaluation is the first step toward managing your joint health and maintaining an active lifestyle as you age.
Conclusion: The Takeaway on SCJ Arthritis and Age
In summary, the answer to the question, what age do people get arthritis in the sternoclavicular joint?, is nuanced. While the degenerative process starts in middle age, with evidence from studies suggesting signs appear as early as 35, the condition rarely becomes symptomatic until later in life, and for many, it remains completely asymptomatic. Increased prevalence and severity are noted with advancing age, particularly after 50. Understanding this timeline can help individuals and their doctors differentiate between normal, age-related changes and the onset of a painful, symptomatic condition. Staying active, managing joint stress, and seeking medical attention for persistent symptoms are key steps in managing SCJ health as you age.
