Acromioclavicular joint injury with muscle injuries (ultrasound)
Presentation
History of fall from a swing. Direct trauma to the right shoulder region. Radiograph was negative for a fracture/ dislocation. Complaining of pain in the acromioclavicular joint and adjacent regions. Referred for ultrasound evaluation of the rotator cuff and other soft tissue structures.
Patient Data
The right acromioclavicular joint shows hypoechoic thickening of the capsule and synovium resulting in mild widening of the space in comparison to the contralateral left joint. However, there is no subluxation/ dislocation. The rotator cuff is intact and shows normal echopattern. There is no effusion in the glenohumeral joint or subacromial-subdeltoid bursa. The trapezius muscle and the anterior head of the deltoid muscle show a focal ill-defined area of loss of normal muscle echopattern with the presence of tiny fluids. However, there is no large defect in either of the muscles. The subcutaneous fat overlying anterior head of the deltoid muscle shows increased echogenicity and fluid clefts.
Case Discussion
An elderly male had shoulder trauma due to a fall. The shoulder radiograph was negative for fracture/ dislocation and ultrasound was requested to check rotator cuff and non-rotator cuff injuries. The ultrasound shows a normal rotator cuff with acromioclavicular joint injury, trapezius and deltoid muscle contusions.
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