Distal clavicle osteolysis
Distal clavicle osteolysis is the painful osseous resorption of the distal clavicle.
Distal clavicle osteolysis most commonly affects young males. It is bilateral in ~20% 1.
There are two distinct forms of distal clavicle osteolysis although these have identical histopathologic and imaging findings 1,2:
- post-traumatic: weeks to more commonly months after injury
- atraumatic: stress-induced overuse, seen in laborers and overhead athletes, especially in weight-lifters
May be normal early in the disease course. Progressive disease can manifest with cortical irregularity, subchondral cysts and erosion/tapering of the distal clavicle 1,3.
Bone marrow edema of the distal clavicle more than the acromion with subchondral cystic change +/- subchondral fracture, and distal clavicle periostitis 1,2. Acromioclavicular joint effusion and capsular edema may be present 1.
See article: distal clavicular erosion (differential).
- 1. Dyan V. Flores, Paola Kuenzer Goes, Catalina Mejía Gómez, Darwin Fernández Umpire, Mini N. Pathria. Imaging of the Acromioclavicular Joint: Anatomy, Function, Pathologic Features, and Treatment. (2020) RadioGraphics. 40 (5): 1355-1382. doi:10.1148/rg.2020200039 - Pubmed
- 2. Johannes B. Roedl, Mika Nevalainen, Felix M. Gonzalez, Christopher C. Dodson, William B. Morrison, Adam C. Zoga. Frequency, imaging findings, risk factors, and long-term sequelae of distal clavicular osteolysis in young patients. (2015) Skeletal Radiology. 44 (5): 659. doi:10.1007/s00256-014-2092-2 - Pubmed
- 3. Steven F DeFroda, Christopher Nacca, Gregory R Waryasz, Brett D Owens. Diagnosis and Management of Distal Clavicle Osteolysis. (2017) Orthopedics. 40 (2): 119. doi:10.3928/01477447-20161128-03 - Pubmed