Acromioclavicular separation…

September 15, 2014

Orthopedics, Shoulder XR, Trauma, XR


This person fell from bike and won’t move their shoulder:

AC separation 1 AC separation 2

On initial evaluation we actually thought this person had a shoulder dislocation (glenohumeral dislocation) because of the significant deformity visible externally.  They had the classic anterior “divot” on the shoulder and wouldn’t perform shoulder range of motion.  We were somewhat surprised when we found an acromioclavicular (AC) separation instead.

This case is a good argument as to why often it is appropriate to obtain pre-reduction X-rays for possible shoulder (glenohumeral) dislocations.  Unless the patient will allow a good exam, sometimes it is very hard to differentiate AC separation from glenohumeral dislocation without imaging.   In this case, if we went directly to attempted “reduction”  it would have been very difficult to “reduce” the shoulder!  Hence the need for an X-ray.

There are six different types/degrees of AC separation that are summed up well on the following LearningRadiology.com webpage:

AC Separation Types

 

Author:  Russell Jones, MD

References

1.  Acromio-clavicular separation.  www.LearningRadiology.com

 

 

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