Type:
Educational Exhibit
Keywords:
Musculoskeletal joint, Ultrasound, Plain radiographic studies, CT, Efficacy studies, Staging, Trauma
Authors:
H. Thalagala, J. Hocking, A. Coulthard; QLD/AU
DOI:
10.1594/ranzcr2016/R-0072
Conclusion
Given the prevalence of AC joint injuries it is important that doctors are aware of the Rockwood classification and how to accurately use it.
Research shows that accuracy of AC joint injury classification could be improved,
be it through additional views,
or the adjunctive imaging techniques such as ultrasound,
CT,
MRI and 4D CT.
This allows the clinician to get a better idea of the extent of the injury,
which will have important ramifications for the eventual management of it.
Unfortunately there are limitations in the utilisation of these methods.
These include: lack of access,
cost of use as well as the potential increase in radiation.
In addition to this,
many of these alternate imaging techniques currently have a narrow evidence base; hence the results could be distorted due to small study sizes.
Despite this,
developments in the analysis of AC joint injuries through these novel imaging methods could be an important factor that improves the accuracy of AC injury classification in the future.
Summary Table:(17)
Rockwood Type
|
AC/CC damage
|
Visual Appearance
|
Measurements
|
I
|
AC: strain CC: intact
|
Normal or slight asymmetry
|
AC < 6mm
CC <13-14mm
|
II
|
AC: rupture CC: partial rupture
|
0-25% clavicle elevation compared to contralateral side
|
AC >6mm
CC normal (<14mm)
|
III
|
AC: rupture CC: rupture
|
25-100% clavicle elevation
|
AC >6mm
CC > 14mm
|
IV
|
AC: rupture CC: rupture
|
Posterior dislocation of clavicle into trapezius muscle
|
AC > 6mm
CC > 14mm
|
V
|
AC: rupture CC: rupture
|
100-300% clavicle elevation
|
AC > 6mm
CC > 25mm
|
VI
|
AC: rupture CC: rupture
|
Clavicle displaced into the subacromial or subcoracoid position
|
-
|