Presentation
Persistent shoulder pain with a remote (more than one year) history of a shoulder injury.
Patient Data
Frontal and lateral radiographs of the right shoulder show separation of the acromioclavicular (AC) joint with marked elevation of the clavicle and significant widening of the coracoclavicular (CC) distance. No fractures are seen. Calcific densities, likely representing dystrophic calcifications, are present inferior to the lateral clavicular end and the conoid tubercle of the clavicle and are consistent with the chronic nature of the injury.
An annotated frontal radiograph of the right shoulder shows a widening of the acromioclavicular (AC) and coracoclavicular (CC) distances, measuring 30.5 mm and 39.8 mm, respectively, consistent with a type V Rockwood injury.
Case Discussion
According to the Rockwood classification of acromioclavicular joint injury, type V is characterized by a markedly elevated clavicle with significantly increased coracoclavicular distance, more than double normal (i.e., >25 mm).
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