Fracture of clavicle with cuff arthropathy

Case contributed by Dr Maulik S Patel


Trauma to left shoulder


AP standing radiograph

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.

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Case information

rID: 15664
Published: 31st Oct 2011
Last edited: 9th Feb 2019
Inclusion in quiz mode: Included

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