Acromioclavicular joint series

Last revised by Andrew Murphy on 23 Mar 2023

The acromioclavicular (AC) joint radiographic series is used to evaluate the acromioclavicular joint and the distal clavicle.

Indications

AC radiographs are performed for a variety of indications including: 

  • shoulder trauma
  • direct blows to the shoulder region
  • following a fall onto an adducted arm
  • suspected dislocation
  • suspected arthritis

Projections

Standard projections
  • AP view
    • erect view demonstrating the AC joint in the anteroposterior plane
    • best view to inspect widening of the AC joint
Additional projections
  • AP with weight bearing
    • also known as a stress view, the patient holds onto a weight on the affected side, placing inferior pressure on the AC joint
    • this view is used to rule out displacement when it is suspected yet not confirmed on the AP view
  • AP comparison views
    • both AC joints are imaged separately, to rule out a suspected displacement or differentially anatomical variation
  • Zanca view
    • AP projection with a 10-15 degree cephalad angle to free the AC joint from superimposition 

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