A 22-year-old male sustained blunt trauma to his anterior chest/sternum while playing recreational American football. He complained of persistent sternal pain, worse with deep inspiration and elevation of the left upper extremity against resistance, despite five days of rest and over-the-counter nonsteroidal anti-inflammatory medication. Radiographs of the bilateral SC joints (AP, bilateral obliques) obtained four weeks following the injury were negative (not shown). Selected images from an MRI of the SC joints obtained seven days after injury are shown in Fig. 1, A-D. Based on the imaging findings, a diagnosis of complete rhomboid ligament avulsion was proposed. The patient was placed in an upper-extremity sling, including a contralateral "figure of 8" harness for six weeks; physical therapy was gradually instituted beginning at four weeks of immobilization. Eighteen months following the original injury, the patient is asymptomatic and has complete range of motion of the left upper extremity.