Radiological diagnosis of acromio clavicular injuries

Abstract

Introduction: According to the literature, acromio-clavicular injuries represent a problem in the contemporary traumatology because of the possible complications. Radiological diagnosis of acromio-clavicular injuries is important for deciding upon the optimal method of treatment. In acromio-clavicular joint (ACJ) research, by routine radiography of the shoulder, small fractures certainly can not be viewed. It should be viewed simultaneously both ACJ, with a cephalic tilt image from 10° to 15°, especially in the small joint suspected fractures. As with other musculoskeletal injuries, ACJ trauma is not sufficient to perform only single plane radiography. Thus, in suspected ACJ dislocations, radiographs should be performed in an axillary lateral view of both shoulders. This image allows assessing the posterior displacement of clavicle and small fractures. Bossart reports the need of stress radiographic examination, with weights suspended from each arm of the patient. Material and methods: The retrospective study was conducted on 83 patients, treated surgically in the Republican Hospital of Traumatology, department Nol, between the years 2000-2011. The Rockwood's classification (1987) and imaging examinations were performed to assess the type of ACJ trauma. Discussions: The distribution of patients by gender was as follows: 79 men and 4 women. Type 3 of lesions were determined in 53 patients, type 4 for was established in 25 cases and the type 5 - in 5 cases. All patients were examined by standard antero-posterior imaging, bilaterally. Rg 10° tilt tube. In 37 cases an axial image was used. Stress radiographs, with 8 kg weights hanging arm, was performed in 3 patients. ACJ angle of 10°-20° was appreciated in 14 patients, 30°-40° - in 27 cases and 50° - in 42 patients. During the research, it was noted that the greater the acromio-clavicular angle the more advanced the degree of dislocation was. Coraco-clavicular distance exceeded the normal range by 50-60%. Conclusions: In order to evaluate the acromio-clavicular injuries it is necessary to examine bilaterally ACJ, using multiple imaging modalities.