[Sonographic diagnosis of the injured acromioclavicular joint. A standardized examination procedure]

The possibility of using ultrasound leads to an improvement and extension of the methods conventionally used for diagnostic examination of the injured acromio-clavicular (AC) joint. Periarticular soft tissues can be assessed, as well as the osseous parts making up the joint. Coraco-clavicular ligaments in particular can be visualized well, and the coraco-clavicular distance can be measured precisely. Evaluation of the ultrasound findings makes classification of the grade of severity of injury according to Tossy much easier. We examined 35 injured AC joints of all grades of severity. With two standard planes of examination--a frontal and a sagittal plane--it was possible to obtain information about the grade severity of the injury in every case. Instability of the joint is diagnosed by measuring the coraco-clavicular distance with and without weights pulling on each arm. Standard X-rays of the shoulder remain mandatory to exclude fractures. When ultrasound examination is possible, however, X-ray examination of the shoulder with weights pulling on the arms is unnecessary.