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Acromioclavicular Joint Injury, Emergency Medicine

Aleksandr M. Tichter and Wallace A. Carter Reviewed 06/2017



  • The acromioclavicular (AC) joint is formed by the articulation of the distal clavicle and the scapular acromion

  • It is stabilized by the AC ligament, coracoclavicular (CC) ligament, an...


Signs and Symptoms


  • Pain to anterior or superior aspect of the shoulder following trauma

  • Pain exacerbated by moving arm across the chest, behind the back, or overhead

  • Mechanism/force will...



  • Ice packs

  • Sling immobilization

  • Cervical spine immobilization if indicated

Initial Stabilization/Therapy

  • Ice packs

  • Sling immobilization

  • Cervical spine immobilization if indicated

  • Analges...



Admission Criteria

  • Open injury

  • Types IV, V, and VI require admission for operative repair

Discharge Criteria

  • Types I and II can be discharged with orthopedic referral

  • Type III should h...

Pearls and Pitfalls

  • Type I and II AC injuries:

    • No increase in CC space

    • Conservative management with rest, ice, sling, and ROM/strength exercises

  • Type III injuries:

    • 100% superior displacement of distal cla...

Additional Reading

  • Bossart  PJ, Joyce  SM, Manaster  BJ, et al. Lack of efficacy of weighted radiographs in diagnosing acute acromioclavicular separation. Ann Emerg Med.  1988;17:47–51.

  • Bussieres ...



  • 831.04 Closed dislocation of acromioclavicular (joint)

  • 840.0 Acromioclavicular (joint) (ligament) sprain

  • 840.8 Sprains and strains of other specified sites of shoulder and upper arm

  • 831.09 Clos...

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