Rockwood II acromioclavicular joint injury with coracoid process avulsion fracture

Case contributed by Dayu Gai
Diagnosis certain

Presentation

Post rugby tackle with right shoulder pain.

Patient Data

Age: 16 years
Gender: Male

There is abnormal elevation of the distal clavicle relative to the acromion, but not beyond the superior acromial border - consistent with a grade II Rockwood acromioclavicular joint injury.  A transverse linear fragment of bone is noted just superior to the mid coracoid process, consistent with an avulsion fracture of the coraclavicular ligaments and possibly the coracoacromial ligaments.  Anatomical glenohumeral joint alignment.  Normal variant azygous lobe.

Case Discussion

A case demonstrating bony changes secondary to ligamentous injury. The linear contour of the acromion-clavicle interval is disrupted suggesting at least a moderate acromioclavicular joint injury.  Avulsion of the mid coracoid process is probably due to coracoclavicular +/- coracoacromial ligamentous avulsion.

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