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Ultrasonographic Diagnosis of Non-displaced Avulsion Fracture of the Acromion: A Case Report.

Lee CH, Choi YA, Lee SU - Ann Rehabil Med (2015)

Bottom Line: A 55-year-old male patient visited our outpatient clinic with shoulder pain resulting from a significant stress at the trapezius muscle during lifting of a steel reinforcement.Simple radiography revealed a calcific deposit over the acromion rather than a fracture.This is the first report demonstrating that ultrasonography has an advantage over radiographs in the diagnosis of an avulsion fracture of the acromion of the scapula.

View Article: PubMed Central - PubMed

Affiliation: Department of Rehabilitation Medicine, Maryknoll Medical Center, Busan, Korea.

ABSTRACT
Avulsion fracture of the acromion is rare. It is difficult to diagnosis because there is little displacement and it occurs even without direct trauma. We experienced a case without direct trauma that was diagnosed with ultrasonography. A 55-year-old male patient visited our outpatient clinic with shoulder pain resulting from a significant stress at the trapezius muscle during lifting of a steel reinforcement. Simple radiography revealed a calcific deposit over the acromion rather than a fracture. Avulsion fracture was identified with ultrasonography. This is the first report demonstrating that ultrasonography has an advantage over radiographs in the diagnosis of an avulsion fracture of the acromion of the scapula.

No MeSH data available.


Related in: MedlinePlus

Radiograph of shoulder in anterior-posterior view showed a small calcific deposit (arrowhead) and a possible fracture line (arrow) in the posterior area of the acromial process at right acromioclavicular joint. The possible fracture line was found after performing ultrasonography examination.
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Figure 2: Radiograph of shoulder in anterior-posterior view showed a small calcific deposit (arrowhead) and a possible fracture line (arrow) in the posterior area of the acromial process at right acromioclavicular joint. The possible fracture line was found after performing ultrasonography examination.

Mentions: A 55-year-old man visited our outpatient clinic with shoulder pain and restricted movement. He had severe shoulder pain which occurred suddenly during the lifting of a steel reinforcement 4 days previously. He had no remarkable trauma or surgical history. It was a first time that he had shoulder pain. In physical examination, a range of motion of the right shoulder was decreased slightly with pain. He had tender points at the right acromioclavicular joint and acromion. There was a positive response in the acromioclavicular joint compression test. We requested radiographs of the shoulder for initial evaluation. There was no definite abnormality in the anterior-posterior view obtained with the both clavicles of the patient bearing weight (Fig. 1). The radiograph of shoulder in anterior-posterior view showed only small calcific deposit at right acromioclavicular joint (Fig. 2). For further evaluation, we conducted ultrasonography of the shoulder. A minimally displaced extracapsular calcifications and defect of the cortical surface at the posterior area of the acromial process was noted (Fig. 3). We could diagnose avulsion fracture with ultrasonography. There was no deltoid or rotator cuff tear. Using real-time ultrasonography, lidocaine hydrochloride 0.5 mL and 40 mg (1 mL) of triamcinolone acetonide was injected around the avulsion fracture of acromion. Anti-inflammatory medication was prescribed and the patient was advised not to do any activities that included lifting. After 4 days, the shoulder pain of patient was subjectively judged to be lessened by half. One month later, the shoulder pain was completely resolved and the patient achieved excellent shoulder function.


Ultrasonographic Diagnosis of Non-displaced Avulsion Fracture of the Acromion: A Case Report.

Lee CH, Choi YA, Lee SU - Ann Rehabil Med (2015)

Radiograph of shoulder in anterior-posterior view showed a small calcific deposit (arrowhead) and a possible fracture line (arrow) in the posterior area of the acromial process at right acromioclavicular joint. The possible fracture line was found after performing ultrasonography examination.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4496519&req=5

Figure 2: Radiograph of shoulder in anterior-posterior view showed a small calcific deposit (arrowhead) and a possible fracture line (arrow) in the posterior area of the acromial process at right acromioclavicular joint. The possible fracture line was found after performing ultrasonography examination.
Mentions: A 55-year-old man visited our outpatient clinic with shoulder pain and restricted movement. He had severe shoulder pain which occurred suddenly during the lifting of a steel reinforcement 4 days previously. He had no remarkable trauma or surgical history. It was a first time that he had shoulder pain. In physical examination, a range of motion of the right shoulder was decreased slightly with pain. He had tender points at the right acromioclavicular joint and acromion. There was a positive response in the acromioclavicular joint compression test. We requested radiographs of the shoulder for initial evaluation. There was no definite abnormality in the anterior-posterior view obtained with the both clavicles of the patient bearing weight (Fig. 1). The radiograph of shoulder in anterior-posterior view showed only small calcific deposit at right acromioclavicular joint (Fig. 2). For further evaluation, we conducted ultrasonography of the shoulder. A minimally displaced extracapsular calcifications and defect of the cortical surface at the posterior area of the acromial process was noted (Fig. 3). We could diagnose avulsion fracture with ultrasonography. There was no deltoid or rotator cuff tear. Using real-time ultrasonography, lidocaine hydrochloride 0.5 mL and 40 mg (1 mL) of triamcinolone acetonide was injected around the avulsion fracture of acromion. Anti-inflammatory medication was prescribed and the patient was advised not to do any activities that included lifting. After 4 days, the shoulder pain of patient was subjectively judged to be lessened by half. One month later, the shoulder pain was completely resolved and the patient achieved excellent shoulder function.

Bottom Line: A 55-year-old male patient visited our outpatient clinic with shoulder pain resulting from a significant stress at the trapezius muscle during lifting of a steel reinforcement.Simple radiography revealed a calcific deposit over the acromion rather than a fracture.This is the first report demonstrating that ultrasonography has an advantage over radiographs in the diagnosis of an avulsion fracture of the acromion of the scapula.

View Article: PubMed Central - PubMed

Affiliation: Department of Rehabilitation Medicine, Maryknoll Medical Center, Busan, Korea.

ABSTRACT
Avulsion fracture of the acromion is rare. It is difficult to diagnosis because there is little displacement and it occurs even without direct trauma. We experienced a case without direct trauma that was diagnosed with ultrasonography. A 55-year-old male patient visited our outpatient clinic with shoulder pain resulting from a significant stress at the trapezius muscle during lifting of a steel reinforcement. Simple radiography revealed a calcific deposit over the acromion rather than a fracture. Avulsion fracture was identified with ultrasonography. This is the first report demonstrating that ultrasonography has an advantage over radiographs in the diagnosis of an avulsion fracture of the acromion of the scapula.

No MeSH data available.


Related in: MedlinePlus