Distal Clavicle Osteolysis

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Distal Clavicle Osteolysis

Authors, Editors, Case Information Author: Karson Mostert, MD Affiliation: Mayo Clinic Co Author(s): Benjamin Kopecky, MD Cara Prideaux, MD Senior Editor: Wesley Troyer, DO Clinical Vignette: A physically active 30-year-old male presents to the sports medicine clinic for anterior shoulder pain that is worse during and after performing push-ups. A positive Scarf test is noted. Type of Probe Used: Linear LA4-18B transducer #1 - Image Short axis view of the left acromioclavicular joint. #2 - Image Short axis view of the left acromioclavicular joint. An increased distance is noted between the acromion and the clavicle. The cortex of the distal clavicle is degraded while the acromion remains intact. #3 - Video View Video A scan from anterior to posterior involving the clavicle on the left of the screen with osteolysis visualized and then acromion on the right side of the screen. Interpretation Image Interpretation: The left acromioclavicular joint is visualized with the clavicle on the left and the acromion on the right. There is noted increased distance between the acromion and the clavicle. The cortex of the distal clavicle is degraded while the acromion remains intact. Teaching Pearl: Distal clavicular osteolysis is an atypical overuse injury occurring most commonly in male athletes, weightlifters, or those performing repetitive overhead activities. The Scarf test can help rule in the pathology while a detailed cervical and neurologic exam can rule out alternative diagnoses. Treatment consists of conservative management with activity modification, NSAIDs, physical therapy followed by corticosteroid injections and surgical resection for refractory cases.
NOTE: For more information, please contact the AMSSM, 4000 W. 114th Street, Suite 100, Leawood, KS 66211 (913) 327-1415.

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Authors, Editors, Case Information

#1 - Image

#2 - Image

#3 - Video

Interpretation

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