Learning objectives
To describe and illustrate the characteristic findings on acromioclavicular joint injury,
making a review of specific anatomic structures involved,
injury mechanisms and classifications.
Background
Injuries of the acromioclavicular joint (ACJ) are common,
particularly affecting athletes who practice contact sports,
usually males.
The most common mechanism of injury is a fall on the shoulder with the arm adducted to the side.
Ligamentous structures surrounding the ACJ are the acromioclavicular,
trapezoid,
conoid,
and coracoacromial ligaments.
Knowlege of the key anatomy structures its crucial for a correct evaluation and injury classification.
Findings and procedure details
We perform a retrospective analysis of 62 patients from 2015 to 2018 with acromioclavicular trauma,
evaluated with conventional radiography,
CT and MRI.
A 64-slice CT scanner and 1.5 or 3 Tesla MRI equipments were used.
Acromioclavicular stability is maintained by the coracoclavicular ligaments (conoid and trapezoid) in addition to the AC capsule and ligaments.
On conventional radiography the use of a 10° to 15° cephalic angulation (Zanca view) is prefered to isolate the ACJ from other structures.
Axillary projections can be performed to evaluate for...
Conclusion
MR is the modality of choicefor evaluation of soft tissue and osseous abnormalities in ACJ injuries.
Knowledge of the anatomy,
mechanisms and specificlocations of injury are fundamental to grant a correct diagnosis and degree of joint stability,
guiding to a correct therapeutic approach.
References
1.
Gorbaty,
J.
D.,
Hsu,
J.
E.,
& Gee,
A.
O.
(2017).
Classifications in Brief: Rockwood Classification of Acromioclavicular Joint Separations.
Clinical Orthopaedics and Related Research,
475(1),
283–287.
https://doi.org/10.1007/s11999-016-5079-6
2.
Rios,
C.
G.,
& Mazzocca,
A.
D.
(2008).
Acromioclavicular Joint Problems in Athletes and New Methods of Management.
Clinics in Sports Medicine,
27(4),
763–788.
https://doi.org/10.1016/j.csm.2008.06.006
3.
Mazzocca,
A.
D.,
Arciero,
R.
A.,
& Bicos,
J.
(2007).
Evaluation and treatment of acromioclavicular joint injuries.
American Journal of Sports Medicine,
35(2),
316–329.
https://doi.org/10.1177/0363546506298022
4.
Favorito,
P.
J.,...