Disclosures: Ajay K. Patel, MD: No financial relationships or conflicts of interest

Case Diagnosis: A 35-year-old female with a left interclavicular ligament tear.

Case Description: A 35-year-old female presented with left parasternal pain that began shortly after a day of kitesurfing. Pain was described as sharp, deep, and nonradiating. She also reported pain-limited left shoulder range of motion with flexion or abduction past 90 degrees; going any further caused discomfort primarily just to the left of the sternum. Physical exam was remarkable for full active and passive range of motion at the left shoulder, however severe anterior sternoclavicular joint dislocation with left shoulder flexion and abduction. MRI chest without contrast was significant for partial tearing of the left interclavicular ligament. The patient underwent a series of ultrasound-guided dextrose prolotherapy injections to the interclavicular ligament: 1 injection of 1-2mL dextrose 50% to the left interclavicular ligament every 2 weeks for a total of 10 injections over 20 weeks.

Setting: Outpatient sports medicine clinicAssessment/

Results: An MRI chest was performed after completion of treatments, which showed a complete resolution of the previous ligament tear. The patient’s sternoclavicular joint subluxation is mild, and much improved from prior. She uses her left arm to do daily activities, but continues to withhold herself from activities that increase stress to the area due to concurrent shoulder injuries.

Discussion: The interclavicular ligament is a flat band that connects both sternal ends of the clavicle and attaches along the manubrium of the sternum. The interclavicular ligament is strongly connected with the sternoclavicular ligaments, and therefore disruption of this ligament can occur with injury to the sternoclavicular joint. Given the nonsurgical nature of our patient’s injury, a trial of prolotherapy was recommended, in order to stimulate tissue healing and restore stability to the injured ligament.

Conclusion: This patient’s symptomatic improvement alongside complete structural repair on MRI, depicts a novel case of dextrose prolotherapy to heal an interclavicular ligament tear.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/kitemare-an-unusual-case-of-chest-pain-in-a-kitesurfer-a-case-report/