Header

UZH-Logo

Maintenance Infos

Standard axillary radiographs of the shoulder may mimic posterior subluxation of the lateral end of the clavicle


Rahm, Stefan; Wieser, Karl; Spross, Christian; Vich, Magdalena; Gerber, Christian; Meyer, Dominik C (2013). Standard axillary radiographs of the shoulder may mimic posterior subluxation of the lateral end of the clavicle. Journal of Orthopaedic Trauma, 27(11):622-626.

Abstract

OBJECTIVES: On standard axillary radiographs of normal shoulders, the clavicle may appear subluxated posteriorly. This subluxation might be viewed as an indication for surgical stabilization in acromioclavicular (AC) injury. The purpose of this study was to assess the reliability of identification of anteroposterior displacements of the AC joint on standard axillary radiographs of the human shoulder.
METHODS: We performed 170 radiographs of the AC joint in 10 cadaveric shoulders using various projection angles. The distance from the anterior margin of the acromion to the distal clavicle was measured to identify an "optimal" view to image the true anteroposterior alignment of normal AC joints.
RESULTS: On the standard axillary view of intact shoulders, we found an average posterior translation of 1.7 mm (range, -3 to 7; SD, 2.8) and of 0.9 mm (range, -5 to 5; SD, 2.8) in an "optimal view," tilted 15 degees dorsal and 15 degees lateral.
CONCLUSIONS: The standard axillary radiograph has a very high sensitivity but poor accuracy in identifying a posterior clavicular translation in the AC joint. We could not identify a reliable modification of the axillary radiographic projection to improve the accuracy. Therefore, an apparent posterior subluxation of the clavicle identified on an axillary radiograph is more likely a false positive finding than an identification of a true pathology.

Abstract

OBJECTIVES: On standard axillary radiographs of normal shoulders, the clavicle may appear subluxated posteriorly. This subluxation might be viewed as an indication for surgical stabilization in acromioclavicular (AC) injury. The purpose of this study was to assess the reliability of identification of anteroposterior displacements of the AC joint on standard axillary radiographs of the human shoulder.
METHODS: We performed 170 radiographs of the AC joint in 10 cadaveric shoulders using various projection angles. The distance from the anterior margin of the acromion to the distal clavicle was measured to identify an "optimal" view to image the true anteroposterior alignment of normal AC joints.
RESULTS: On the standard axillary view of intact shoulders, we found an average posterior translation of 1.7 mm (range, -3 to 7; SD, 2.8) and of 0.9 mm (range, -5 to 5; SD, 2.8) in an "optimal view," tilted 15 degees dorsal and 15 degees lateral.
CONCLUSIONS: The standard axillary radiograph has a very high sensitivity but poor accuracy in identifying a posterior clavicular translation in the AC joint. We could not identify a reliable modification of the axillary radiographic projection to improve the accuracy. Therefore, an apparent posterior subluxation of the clavicle identified on an axillary radiograph is more likely a false positive finding than an identification of a true pathology.

Statistics

Citations

6 citations in Web of Science®
9 citations in Scopus®
Google Scholar™

Altmetrics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Balgrist University Hospital, Swiss Spinal Cord Injury Center
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2013
Deposited On:03 Feb 2014 16:02
Last Modified:07 Dec 2017 08:27
Publisher:Lippincott, Williams & Wilkins
ISSN:0890-5339
Publisher DOI:https://doi.org/10.1097/BOT.0b013e31828f912c
PubMed ID:23481922

Download

Full text not available from this repository.
View at publisher