Acromioclavicular joint injury

Question 1

Hx

Answer 1

16 yr old boy severe pain over R AC joint after rugby tackle this morning, fell on outstretched r hand, pain with movement of r arm

Question 2

look/ inspect

Answer 2

deformity [lump palpated/ visualised over AC joint

tenting of skin - impending open fracture

Question 3

feel

Answer 3

tenderness over AC joint

Question 4

active and passive movement

Answer 4

reduced ROM R shoulder due to pain

Question 5

resisted movement

Answer 5

pain with resisted movements

Question 6

special tests

Answer 6

scarf test positive

Question 7

other tests

Answer 7

upper limb neuro exam

vascular assessment upper limb

Question 8

why is AC joint sprain likely?

Answer 8

typical hx and exam findings, lump/ tenderness over the clavicle, reduced ROM of shoulder

Question 9

DDx

Answer 9

AC joint subluxation/dislocation - need to rule out with imaging

Question 10

investigations

Answer 10

x-ray of clavicle/AC joint

Question 11

non-op tx

Answer 11

sling with ROM exercises 2-4 wks later
analgesia, paracetamol + NSAIDS
physio

Question 12

op tx

Answer 12

if coracoclavicular ligaments are disrupted