acromioclavicular joint ( RID1895 )
XRs were reported as normal, though there is relative cranial displacement of the distal clavicle, without widening of either the AC joint or coracoclavicular interval. MRI shows fluid signal in the coracoclavicular space with tear of the trapezoid (lateral, red arrow) component and either Gr 1 sprain or partial tear of the conoid (medial, white arrow) component of the cc ligament. I see only sprain without discontinuity of the AC joint capsule with mild subchondral marrow signal changes and small ACJ effusion. There is supraspinatus tendinosis without tear. Based on the Rockwood XR classification this would be a Class II AC separation. The attached article that reviews MRI findings in AC separation retrofit the MRI findings to the Rockwood schema, but I am left confused how to classify this. Would this be treated conservatively, as a Class II separation based on XR findings and partial tear of the CC ligament? [ Article ]
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