Lateral roentgenographic projections of the acromioclavicular joint

Abstract

Although the acromioclavicular joint is frequently injured in both contact and noncontact sports, the treatment is nonspecific, as demonstrated by the numerous methods of treatment currently employed. Despite treatment, some shoulders still develop chronic symptoms and disability during overhead lifting, throwing, and swinging. Perhaps these difficulties develop as a result of an incomplete evaluation of the joint and because the exact nature of the injury is not appreciated. Therefore, the shoulder develops chronic problems. We have routinely utilized a lateral roentgenogram of the acromion to evaluate the acromioclavicular joint. This has significantly aided us in the diagnosis and treatment of acromioclavicular joint injuries, especially when there was posterior dislocation of the distal clavicle. This presentation reviews standard roentgenography of the acromioclavicular joint and illustrates the method of obtaining the lateral projection as described by O. M. Alexander. We will also show how this method has helped us clinically in detecting posterior dislocations of the distal end of the clavicle.

New quantitative radiographic parameters for vertical and horizontal instability in acromioclavicular joint dislocations

“…Hence, it has been considered as a potential indication for operative stabilization [ 21 ]. The presence and degree of horizontal instability is semi-quantitatively assessed in the lateral Alexander view [ 7 , 22 , 23 ] or by obtaining single or multiple Axillary views [ 10 ]. But standard Axillary radiographs have been shown to mimic posterior subluxation of the lateral end of the clavicle [ 11 ].…”

Arthroscopically Assisted Stabilization of Acute High-Grade Acromioclavicular Joint Separations

“…Horizontal stability is evaluated on bilateral Alexander views. 1,17 A stable situation is defined as a clavicle that is in line with the acromion (20 points). The clavicle is subluxated if the difference to the acromion is less than one clavicle shaft width (10 points).…”

Improved identification of unstable acromioclavicular joint injuries in a clinical population using the acromial center line to dorsal clavicle radiographic measurement

“…5,12 The lateral Alexander view may be more appropriate for semiquantitative assessment. 15,19 In a previously published in vitro study, we demonstrated that the measured AC-DC distance in lateral Alexander views showed excellent interobserver reliability, as well as higher correlation with CT-measured vertical displacement, when compared with the CC distance. 20 An omission from that study was assessment of the accuracy of AC-DC in measuring the total AC joint displacement, that is, the vector magnitude of combined vertical and horizontal displacement.…”

“…Lateral shoulder Alexander views were obtained with the patient standing as for a shoulder Y-view at a 45 angle to the detector, although the injured arm cross-adducted in front of the chest with the hand resting in the contralateral axilla. 1,19 The following measurements were performed bilaterally on admission radiographs: CC distance in AP Zanca view and AC-DC in lateral Alexander views ( Fig. 1).…”