Presence of Additional Pathology in Low-Grade Acromioclavicular Joint Injuries

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Radiology

Background:

• Low-grade acromioclavicular (AC) joint injuries (Type I-III) are common, particularly in athletes.
• Clinical and radiographic evaluations may not fully capture the extent of injury.
• Magnetic resonance imaging (MRI) offers detailed visualization of soft tissues and bone.

Purpose of the Study:

• To investigate the prevalence of additional pathologies in patients with low-grade AC joint injuries using MRI.
• To determine if MRI findings alter the classification or perceived severity of these injuries.
• To assess the potential impact of identifying additional pathologies on diagnostic and treatment guidelines.

Main Methods:

• A prospective case series involving 29 patients (aged 18-65) with Type I-III AC joint injuries.
• Patients underwent MRI within 21 days of injury, with all injuries managed nonoperatively.
• Fellowship-trained musculoskeletal radiologists reported all identified pathologies in a standardized manner.

Main Results:

• MRI reclassified the injury type in 16 of 29 patients.
• Commonly identified additional pathologies included muscle injuries (14), rotator cuff tears (5), and labral tears (5).
• Other findings included a nondisplaced fracture and an intra-articular body.

Conclusions:

• MRI findings suggest that low-grade AC joint injuries often involve more significant pathology than initially diagnosed clinically.
• The identification of associated injuries may necessitate a revision of current diagnostic and treatment protocols for AC joint injuries.
• Further research is warranted to explore the clinical implications of these findings on patient outcomes.