Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
European Radiology
Published in: European Radiology 2/2017

01-02-2017 | Musculoskeletal

Ultrasound of the coracoclavicular ligaments in the acute phase of an acromioclavicular disjonction: Comparison of radiographic, ultrasound and MRI findings

Authors: Marie Faruch Bilfeld, Franck Lapègue, Hélène Chiavassa Gandois, Marie Aurélie Bayol, Nicolas Bonnevialle, Nicolas Sans

Published in: European Radiology | Issue 2/2017

Login to get access

Abstract

Objectives

Acromioclavicular joint injuries are typically diagnosed by clinical and radiographic assessment with the Rockwood classification, which is crucial for treatment planning. The purpose of this study was to describe how the ultrasound findings of acromioclavicular joint injury compare with radiography and MRI findings.

Methods

Forty-seven patients with suspected unilateral acromioclavicular joint injury after acute trauma were enrolled in this prospective study. All patients underwent digital radiography, ultrasound and 3T MRI. A modified Rockwood classification was used to evaluate the coracoclavicular ligaments. The classifications of acromioclavicular joint injuries diagnosed with radiography, ultrasound and MRI were compared. MRI was used as the gold standard.

Results

The agreement between the ultrasound and MRI findings was very good, with a correlation coefficient of 0.83 (95 % CI: 0.72–0.90; p < 0.0001). Ultrasound detected coracoclavicular ligament injuries with a sensitivity of 88.9 %, specificity of 90.0 %, positive predictive value of 92.3 % and negative predictive value of 85.7 %. The agreement between the ultrasound and radiography findings was poor, with a correlation coefficient of 0.69 (95 % CI: 0.51–0.82; p < 0.0001).

Conclusion

Ultrasound is an effective examination for the diagnostic work-up of lesions of the coracoclavicular ligaments in the acute phase of an acromioclavicular injury.

Key Points

• Ultrasound is appropriate for acute acromioclavicular trauma due to its accessibility.
• Ultrasound contributes to the diagnostic work-up of acute lesions of the coracoclavicular ligaments.
• Ultrasound is appropriate in patients likely to benefit from surgical treatment.
• Ultrasound could be a supplement to standard radiography in acute acromioclavicular trauma.
Literature
1.
Melenevsky Y, Yablon CM, Ramappa A, Hochman MG (2011) Clavicle and acromioclavicular joint injuries: a review of imaging, treatment, and complications. Skelet Radiol 40(7):831–42CrossRef
2.
Rockwood C, William G, Toung D (1996) Acromioclavicular injuries. Fractures in adults. p. 1341-1413
3.
Tauber M (2013) Management of acute acromioclavicular joint dislocations: current concepts. Arch Orthop Trauma Surg 133(7):985–95CrossRefPubMed
4.
Alyas F, Curtis M, Speed C, Saifuddin A, Connell D (2008) MR imaging appearances of acromioclavicular joint dislocation. Radiographics 28(2):463–479CrossRefPubMed
5.
Antonio GE, Cho JH, Chung CB, Trudell DJ, Resnick D (2003) Pictorial essay. MR imaging appearance and classification of acromioclavicular joint injury. AJR Am J Roentgenol 180(4):1103–10CrossRefPubMed
6.
Heer G, Götz J, Anders S, Grifka J, Hedtmann A (2006) Ultrasound evaluation of the acromioclavicular joint--a correlation of anatomical and sonographical findings. Ultraschall Med 27(6):549–52CrossRefPubMed
7.
Iovane A, Midiri M, Galia M, Bartolotta TV, Abate M, Sorrentino F et al (2004) Acute traumatic acromioclavicular joint lesions: role of ultrasound versus conventional radiography. Radiol Med 107(4):367–75PubMed
8.
Kock HJ, Jurgens C, Hirche H, Hanke J, Schmit-Neuerburg KP (1996) Standardized ultrasound examination for evaluation of instability of the acromioclavicular joint. Arch Orthop Trauma Surg 115(3-4):136–40CrossRefPubMed
9.
Peetrons P, Bédard JP (2007) Acromioclavicular joint injury: enhanced technique of examination with dynamic maneuver. J Clin Ultrasound 35(5):262–7CrossRefPubMed
10.
Heers G, Hedtmann A (2005) Correlation of ultrasonographic findings to Tossy’s and Rockwood’s classification of acromioclavicular joint injuries. Ultrasound Med Biol 31(6):725–32CrossRefPubMed
11.
Testut L, Jacob O (1921) Traité d’anatomie topographique avec applications médicochirurgicales. Doin. Paris; p. 756-74
12.
Walton J, Mahajan S, Paxinos A, Marshall J, Bryant C, Shnier R et al (2004) Diagnostic values of tests for acromioclavicular joint pain. J Bone Joint Surg Am 86-A(4):807–12CrossRefPubMed
13.
Mazzocca AD, Arciero RA, Bicos J (2007) Evaluation and treatment of acromioclavicular joint injuries. Am J Sports Med 35(2):316–29CrossRefPubMed
14.
Mikek M (2008) Long-term shoulder function after type I and II acromioclavicular joint disruption. Am J Sports Med 36(11):2147–50CrossRefPubMed
15.
Smith TO, Chester R, Pearse EO, Hing CB (2011) Operative versus non-operative management following Rockwood grade III acromioclavicular separation: a meta-analysis of the current evidence base. J Orthop Traumatol 12(1):19–27CrossRefPubMedPubMedCentral
16.
Nemec U, Oberleitner G, Nemec SF, Gruber M, Weber M, Czerny C et al (2011) MRI versus radiography of acromioclavicular joint dislocation. AJR Am J Roentgenol 197(4):968–73CrossRefPubMed
17.
Beris A, Lykissas M, Kostas-Agnantis I, Vekris M, Mitsionis G, Korompilias A (2013) Management of acute acromioclavicular joint dislocation with a double-button fixation system. Injury 44(3):288–92CrossRefPubMed
18.
Stucken C, Cohen SB (2015) Management of acromioclavicular joint injuries. Orthop Clin N Am 46(1):57–66CrossRef
19.
Schaefer FK, Schaefer PJ, Brossmann J, Hilgert RE, Heller M, Jahnke T (2006) Experimental and clinical evaluation of acromioclavicular joint structures with new scan orientations in MRI. Eur Radiol 16(7):1488–93CrossRefPubMed
20.
Barnes CJ, Higgins LD, Major NM, Basamania CJ (2004) Magnetic resonance imaging of the coracoclavicular ligaments: its role in defining pathoanatomy at the acromioclavicular joint. J Surg Orthop Adv 13(2):69–75PubMed
21.
Boileau P, Old J, Gastaud O, Brassart N, Roussanne Y (2010) All-arthroscopic Weaver-Dunn-Chuinard procedure with double-button fixation for chronic acromioclavicular joint dislocation. Arthroscopy 26(2):149–60CrossRefPubMed
22.
Bossart PJ, Joyce SM, Manaster BJ, Packer SM (1988) Lack of efficacy of « weighted » radiographs in diagnosing acute acromioclavicular separation. Ann Emerg Med 17(1):20–4CrossRefPubMed
Metadata
Title
Ultrasound of the coracoclavicular ligaments in the acute phase of an acromioclavicular disjonction: Comparison of radiographic, ultrasound and MRI findings
Authors
Marie Faruch Bilfeld
Franck Lapègue
Hélène Chiavassa Gandois
Marie Aurélie Bayol
Nicolas Bonnevialle
Nicolas Sans
Publication date
01-02-2017
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 2/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-016-4413-4

Other articles of this Issue 2/2017

European Radiology 2/2017 Go to the issue

Breast

Independent value of image fusion in unenhanced breast MRI using diffusion-weighted and morphological T2-weighted images for lesion characterization in patients with recently detected BI-RADS 4/5 x-ray mammography findings

Gastrointestinal

Outcome and CT differentiation of gallbladder neuroendocrine tumours from adenocarcinomas

Magnetic Resonance

Altered signal intensity of active enhancing inflammatory lesions using post-contrast double inversion recovery MR sequence

Neuro

The value of qualitative and quantitative assessment of lesion to cerebral cortex signal ratio on double inversion recovery sequence in the differentiation of demyelinating plaques from non-specific T2 hyperintensities

Musculoskeletal

C-arm flat-panel CT arthrography of the shoulder: Radiation dose considerations and preliminary data on diagnostic performance

Cardiac

Value of a noise-optimized virtual monoenergetic reconstruction technique in dual-energy CT for planning of transcatheter aortic valve replacement