Fracture of clavicle with cuff arthropathy

Case contributed by Dr Maulik S Patel

Presentation

Trauma to left shoulder

AP standing radiograph

Modality: X-ray

Fracture of outer end of clavicle is seen. Coraco-clavicular distance is maintained.

There is reduction of acromio-humeral space suggest proximal migration of humeral head.

Case Discussion

There are two positive findings.

Fracture of the outer end of clavicle is due to recent trauma.

Proximal migration of humeral head - represents chronic cuff tear.

Acromio-humeral distance of less than 6 mm is an abnormal finding. When there is full width tear of supra and infraspinatus tendons, deltoid pulls humeral up and the result is proximal migration of humeral head. This occurs with chronic cuff tear.  Later, there will be subchondral sclerosis involving adjacent surface of acromian and humeral head.  When combination of these findings is present, term cuff arthropathy is used. 

Radiograph of shoulder in standing position is must.

In supine position, there is apparently false proximal migration of humeral head.

PlayAdd to Share

Case Information

rID: 15664
Case created: 31st Oct 2011
Last edited: 19th Dec 2015
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

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

Alert accept Thank you for updating your details.