From the Research
To evaluate a protruding collar bone, first determine if it's a new injury or a longstanding condition, and seek medical attention promptly if it's a recent injury, as it could indicate a clavicle fracture or acromioclavicular (AC) joint separation, and consider the most recent evidence from 1 that suggests a paradigm shift towards operative treatment for displaced clavicle fractures. When evaluating a protruding collar bone, it's essential to consider the patient's history and physical examination findings, as well as imaging studies, to determine the underlying cause and appropriate treatment.
Key Considerations
- Determine if the protrusion is a new injury or a longstanding condition
- Perform a physical examination to check for pain, swelling, deformity, and shoulder function
- Use imaging studies, such as X-rays, CT scans, or MRI, to visualize bone alignment and potential fractures
- Consider the classification systems and surgical indications for clavicle fractures, as reviewed in 2
Treatment Options
- For mild cases without significant displacement, treatment may involve pain management with acetaminophen or NSAIDs, rest, ice application, and possibly a sling for 1-2 weeks
- More severe injuries may require surgical intervention, especially if the bone fragments are significantly displaced or there's risk to surrounding structures, as discussed in 1
- For longstanding and painless protrusions, it may simply represent normal anatomy, as some people naturally have more prominent collar bones due to body composition or genetics
Diagnostic Accuracy
- The diagnostic accuracy of history, physical examination, and bedside ultrasound for diagnosing extremity fractures, including clavicle fractures, has been evaluated in 3, which suggests that EP US is an accurate diagnostic test to rule in or rule out extremity fractures
- However, the diagnostic accuracy for history and physical examination are inconclusive, and further research is needed to understand the accuracy of ED US when combined with history and physical examination for upper and lower extremity fractures.