Articles

Cases

Courses

Rockwood classification of acromioclavicular joint injury

Last revised by Tariq Walizai on 1 Jul 2024

Citation, DOI, disclosures and article data

Citation:

Gaillard F, Walizai T, Murphy A, et al. Rockwood classification of acromioclavicular joint injury. Reference article, Radiopaedia.org (Accessed on 09 Dec 2024) https://doi.org/10.53347/rID-845

DOI:

https://doi.org/10.53347/rID-845

Permalink:

https://radiopaedia.org/articles/845

rID:

845

Article created:

2 May 2008, Frank Gaillard ◉ ◈

Disclosures:

At the time the article was created Frank Gaillard had no recorded disclosures.

View Frank Gaillard's current disclosures

Last revised:

1 Jul 2024, Tariq Walizai

Disclosures:

At the time the article was last revised Tariq Walizai had no financial relationships to ineligible companies to disclose.

View Tariq Walizai's current disclosures

Revisions:

46 times, by 27 contributors - see full revision history and disclosures

Systems:

Musculoskeletal

Sections:

Classifications

Tags:

shoulder

Synonyms:

Acromioclavicular joint injury classification
Rockwood classification
Acromioclavicular injury classification
Rockwood classification of AC joint injury

The Rockwood classification (1998) is the most commonly used (c.2024) classification system in use for acromioclavicular joint injuries ^3,8,9.

The Rockwood classification takes into account not only the acromioclavicular joint itself but also the coracoclavicular ligament, the deltoid, and trapezius muscles, whilst considering the direction of dislocation of the clavicle with respect to the acromion. Essentially types IV, V, and VI are variants of type III ⁶.

type I: normal radiographic appearance with clavicle not elevated with respect to the acromion
- AC ligament: mild sprain
- CC ligament: intact
- joint capsule: intact
- deltoid muscle: intact
- trapezius muscle: intact
type II: widened acromioclavicular joint (>7mm) with <25% clavicular elevation
- AC ligament: ruptured
- CC ligament: sprain
- joint capsule: ruptured
- deltoid muscle: minimally detached
- trapezius muscle: minimally detached
type III: clavicle elevated above the superior border of the acromion but the coracoclavicular distance is less than twice normal (i.e. <25 mm) or 5mm greater than this distance on the contralateral side
- AC ligament: ruptured
- CC ligament: ruptured
- joint capsule: ruptured
- deltoid muscle: detached
- trapezius muscle: detached
type IV: clavicle displaced posterior into the trapezius, which is rare
- AC ligament: ruptured
- CC ligament: ruptured
- joint capsule: ruptured
- deltoid muscle: detached
- trapezius muscle: detached
type V: clavicle is markedly elevated and coracoclavicular distance is more than double normal (i.e. >25 mm) - bilateral weight-bearing projections are able to distinguish type V injuries
- AC ligament: ruptured
- CC ligament: ruptured
- joint capsule: ruptured
- deltoid muscle: detached
- trapezius muscle: detached
type VI: clavicle inferiorly displaced behind coracobrachialis and biceps tendons, which is rare
- AC ligament: ruptured
- CC ligament: ruptured
- joint capsule: ruptured
- deltoid muscle: detached
- trapezius muscle: detached

Quiz questions

References

Incoming Links

Promoted articles (advertising)

{"current_user":null,"inclusions":[{"imageId":51762506,"studyId":82966,"caseSlug":"rockwood-classification-of-acromioclavicular-joint-injury","caption":"Figure 1: Rockwood classification of acromioclavicular joint injury ","isStack":false,"diagnosticCertainty":"not_applicable","thumbnail":"https://prod-images-static.radiopaedia.org/images/51762506/7f8d4c4ea775bbae8d045a40e997d9_big_gallery.jpeg"},{"imageId":23686,"studyId":37843,"caseSlug":"normal-acromioclavicular-joint","caption":"Case 1: normal acromioclavicular joint ","isStack":false,"diagnosticCertainty":"not_applicable","thumbnail":"https://prod-images-static.radiopaedia.org/images/23686/5b5dd9e60424081bb99a9f07f99ff4_big_gallery.jpeg"},{"imageId":2251689,"studyId":19097,"caseSlug":"rockwood-classification-system-of-acromioclavicular-joint-injuries","caption":"Figure 2: illustration - Rockwood types 1 - 6","isStack":false,"diagnosticCertainty":"not_applicable","thumbnail":"https://prod-images-static.radiopaedia.org/images/2251689/4672531fd9472063b29e1941f35dc1_big_gallery.jpg"},{"imageId":6559216,"studyId":28887,"caseSlug":"acromioclavicular-joint-injury-type-1-1","caption":"Case 2: type I","isStack":false,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/6559216/1de131060e3e11b681cc093de0f95f_big_gallery.JPG"},{"imageId":25582090,"studyId":55924,"caseSlug":"rockwood-classification-of-acromioclavicular-joint-injury-annotated-radiographs-1","caption":"Figure 3: annotated radiographs","isStack":false,"diagnosticCertainty":"not_applicable","thumbnail":"https://prod-images-static.radiopaedia.org/images/25582090/bb05bb6da3773ce455ec60b26955dd_big_gallery.jpeg"},{"imageId":52116233,"studyId":85727,"caseSlug":"acromioclavicular-joint-injury-type-ii-6","caption":"Case 3: type II","isStack":false,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/52116233/6ee9ea7aff33bc4db4cedb08a4640f_big_gallery.jpeg"},{"imageId":2214299,"studyId":18969,"caseSlug":"acromioclavicular-joint-injury-type-ii-7","caption":"Case 4: type II","isStack":true,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/2214299/55b1849c5b79e4285b500fbe9402d9_big_gallery.jpg"},{"imageId":23685,"studyId":7437,"caseSlug":"acromioclavicular-joint-injury-type-iii-3","caption":"Case 5: type III","isStack":false,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/23685/d25c4bee1cd6d15a7fa80fce75ec3f_big_gallery.jpeg"},{"imageId":8210467,"studyId":31649,"caseSlug":"acromioclavicular-joint-injury-type-3-1","caption":"Case 6: type III","isStack":false,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/8210467/ace9514a6c713dcc601eac85d5f03f_big_gallery.jpeg"},{"imageId":26933576,"studyId":55193,"caseSlug":"acromioclavicular-joint-injury-grade-ii-9","caption":"Case 7: type III","isStack":false,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/26933576/e5885b2127f96d94b629cb0bab5475_big_gallery.jpeg"},{"imageId":43938060,"studyId":73215,"caseSlug":"acromioclavicular-joint-dissociation-type-iv-1","caption":"Case 8: type IV","isStack":false,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/43938060/4d9d76f34779fa066a93c7068a78f8_big_gallery.jpeg"},{"imageId":43938059,"studyId":73215,"caseSlug":"acromioclavicular-joint-dissociation-type-iv-1","caption":"Case 9: type IV","isStack":false,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/43938059/1c7c1b634022ef50ba6fd9c8f770ab_big_gallery.jpeg"},{"imageId":51076652,"studyId":80133,"caseSlug":"acromioclavular-joint-disruption-treated-with-coracoclavicular-ligament-reconstruction","caption":"Case 10: type IV treated with coracoclavicular ligament reconstruction","isStack":false,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/51076652/9b634783d2a6b9af42ce3c4b9dac21_big_gallery.jpeg"},{"imageId":21935446,"studyId":48582,"caseSlug":"acromioclavicular-joint-injury-type-v-2","caption":"Case 11: type V","isStack":false,"diagnosticCertainty":"confirmed_unsubstantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/21935446/0c4575792b7246d9ad63af97c90f1f_big_gallery.jpeg"},{"imageId":1183989,"studyId":14076,"caseSlug":"acromioclavicular-joint-dislocation-3","caption":"Case 12: type V (MRI)","isStack":true,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/1183989/f95191d25c75481034ae960c5cae03_big_gallery.jpg"},{"imageId":53353078,"studyId":95036,"caseSlug":"acromioclavicular-joint-injury-rockwood-iii-1","caption":"Case 13: type III","isStack":true,"diagnosticCertainty":"confirmed_unsubstantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/53353078/11_big_gallery.jpeg"},{"imageId":54406331,"studyId":103086,"caseSlug":"acromioclavicular-joint-injury-type-v-3","caption":"Case 14: type V, annotated","isStack":false,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/54406331/V_g_lap01_big_gallery.jpeg"},{"imageId":66308780,"studyId":151221,"caseSlug":"acromioclavicular-joint-injury-rockwood-type-iv-1","caption":"Case 15: type 4","isStack":false,"diagnosticCertainty":"confirmed_substantiated","thumbnail":"https://prod-images-static.radiopaedia.org/images/66308780/f682c1e7db441a52f25f1675350ef568d9cd145a6d48268d98b35aeb441e9013_big_gallery.jpeg"}],"ddx_inclusions":[],"lang":"gb"}

Updating… Please wait.

Unable to process the form. Check for errors and try again.

Thank you for updating your details.

Rockwood classification of acromioclavicular joint injury

Citation, DOI, disclosures and article data

On this page:

Usage

Classification

See also

Quiz questions

References

Incoming Links

Related articles: Fractures

Promoted articles (advertising)

Articles

By Section:

By System:

Cases

Radiopaedia.org