The Value of Weighted Views of the Acromioclavicular                     Joint

Yap, J.; Curl, Leigh Ann; Kvitne, Ronald S.; McFarland, Edward G.

doi:10.1177/03635465990270062001

Cited by 35 publications

(16 citation statements)

References 20 publications

(14 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This opinion prevailed in the upcoming years, and the use of weighted radiographs became less popular. Yap et al published a survey showing that a large majority of the specialized American shoulder and elbow community did not use weighted views in daily practice [ 32 ]. However, recently, Izadpanah et al and Ibrahim et al published studies indicating that stress views provide additional information helping to guide management [ 12 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

The acutely injured acromioclavicular joint – which imaging modalities should be used for accurate diagnosis? A systematic review

Pogorzelski

Beitzel

Ranuccio

et al. 2017

BMC Musculoskelet Disord

View full text Add to dashboard Cite

BackgroundThe management of acute acromioclavicular (AC) joint injuries depends on the degree of injury diagnosed by the Rockwood classification. Inadequate imaging and not selecting the most helpful imaging protocols can often lead to incorrect diagnosis of the injury. A consensus on a diagnostic imaging protocol for acute AC joint injuries does not currently exist. Therefore we conducted a systematic review of the literature considering three diagnostic parameters for patients with acromioclavicular (AC) joint injuries: 1) Assessment of vertical instability; 2) Assessment of horizontal instability; 3) Benefit of weighted panoramic views.MethodsInternet databases were searched in March 2016 using the terms (“AC joint” OR “acromioclavicular joint”) AND (MRI OR MR OR radiograph OR X-ray OR Xray OR ultrasound OR “computer tomography” OR “computed tomography” OR CT). Diagnostic, prospective, retrospective, cohort and cross- sectional studies were included to compare their use of different radiological methods. Case reports, cadaveric studies, and studies concerning chronic AC injuries and clinical outcomes were excluded.ResultsThis search returned 1359 citations of which 1151 were excluded based on title, 116 based on abstract and 75 based on manuscript. 17 studies were included for review and were analyzed for their contributions to the three parameters of interest mentioned above. The inter- and intra-observer reliability for diagnosing vertical instabilities of the clavicle using x-ray alone show a high level of reproducibility while for horizontal instabilities the values were much more variable. In general, digitally measured parameters seem to be more precise and reliable between investigators than visual classification alone. Currently, evidence for the value of weighted views and other additional diagnostic imaging to supplement standard x-rays is controversial.ConclusionTo date there is no consensus on a gold standard for diagnostic measures needed to classify acute AC joint injuries. The inter- and intra-observer reliability for diagnosing vertical instabilities of the clavicle using bilateral projections show a high level of reproducibility while for horizontal instabilities the results are much more inconsistent. There is currently no clear consensus on a protocol for image-based diagnosis and classification of acute AC joint injuries, leading to a lack of confidence in reproducibility and reliability.

show abstract

Section: Discussionmentioning

confidence: 99%

The acutely injured acromioclavicular joint – which imaging modalities should be used for accurate diagnosis? A systematic review

Pogorzelski

Beitzel

Ranuccio

et al. 2017

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

“…64 Weighted "stress" views, in which the patient is imaged with and without 5-to 15-pound weights in both hands, can help identify distal clavicular and AC joint injuries, although their utility is controversial. 68 CT can be useful for cases in which the type of fracture, joint involvement, or degree of displacement is uncertain, and it may be useful for preoperative planning. 69 MRI is not typically used to evaluate distal clavicular fractures, although it does provide excellent visualization of ligamentous structures.…”

Section: Imaging Of Distal Clavicular Fracturesmentioning

confidence: 99%

Fractures Around the Shoulder: Radiologic Update on Surgical Fixation Techniques

Gaetke‐Udager

Yablon

2019

Semin Musculoskelet Radiol

View full text Add to dashboard Cite

Although radiologists are likely familiar with basic fracture patterns around the shoulder, certain fracture types in this area have particularly relevant and controversial clinical management issues. These include proximal humeral fractures, in which conservative management is favored but some patients receive surgical treatment; glenoid fractures and Hill-Sachs lesions, in which surgery may be performed depending on the amount of bone loss; and distal clavicular fractures, in which certain displaced fractures have high rates of nonunion, but there is no clearly favored surgical technique. Knowledge of the different clinical issues and surgical options can aid the radiologist in identifying key imaging findings and creating a useful report.

show abstract

“…This specialized view is an AP X-ray with the beam angled 12-15° cephalad to avoid the overlap of the clavicle with the scapular spine (Zanca, 1971). Because of the limited value in providing new information and discomfort to the patient, stress views are no longer recommended (Yap et al, 1999). If the AC joint demonstrates superior displacement, but the CC distance is unchanged, the coracoid should be evaluated for fractures, and additional views may need to be obtained.…”

Section: Radiographsmentioning

confidence: 99%