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Weighted or internal rotation radiographs are not useful in the classification of acromioclavicular joint dislocations

Nordin, Jonas S. LU ; Mogianos, Felicia ; Hauggaard, Anders LU and Lunsjö, Karl LU (2020) In Acta Radiologica
Abstract

Background: Weighted radiographs are performed to classify acromioclavicular joint dislocations; however, the evidence regarding their usefulness is conflicting. Laboratory studies suggest that internal rotation views can replace weighted radiographs, but this has not been clinically evaluated. Purpose: To evaluate whether weighted or internal rotation radiographs uncovers more high-grade acromioclavicular joint dislocations than non-weighted radiographs. Material and Methods: A total of 162 patients with acromioclavicular joint dislocations were prospectively included. After applying exclusion criteria, 140 remained. Three panorama radiographs, including both coracoclavicular intervals, were completed of each participant: first, a... (More)

Background: Weighted radiographs are performed to classify acromioclavicular joint dislocations; however, the evidence regarding their usefulness is conflicting. Laboratory studies suggest that internal rotation views can replace weighted radiographs, but this has not been clinically evaluated. Purpose: To evaluate whether weighted or internal rotation radiographs uncovers more high-grade acromioclavicular joint dislocations than non-weighted radiographs. Material and Methods: A total of 162 patients with acromioclavicular joint dislocations were prospectively included. After applying exclusion criteria, 140 remained. Three panorama radiographs, including both coracoclavicular intervals, were completed of each participant: first, a weighted radiograph with 5-kg weights suspended from the wrists; second, a non-weighted radiograph; and third, an internal rotation radiograph. The coracoclavicular intervals were measured by two radiologists independently, and measurements were translated into Rockwood classifications. The classifications and measurements derived from the different radiographic views were compared. Results: Weighted radiographs caused no significant changes in classification. For the internal rotation views, there was a significant change in classification for radiologist 2; however, the reason was that more injuries were downgraded compared to the non-weighted views. Relative to the non-weighted radiographs, the mean increase of the coracoclavicular interval on the injured side in the weighted view was 0.5 mm (95% confidence interval [CI] 0.37–0.65) and in the internal rotation view 0.2 mm (95% CI 0.04–0.33). While these changes were statistically significant, they were small and not clinically important. Conclusion: This study does not support the use of weighted and internal rotation radiographs in the classification of acromioclavicular joint dislocations.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
athletic injuries, comparative studies, Conventional radiography, joints, shoulder, trauma
in
Acta Radiologica
publisher
SAGE Publications
external identifiers
  • pmid:32660317
  • scopus:85087934116
ISSN
0284-1851
DOI
10.1177/0284185120939270
language
English
LU publication?
yes
id
6367efb8-0577-4563-a32e-4420adf31d14
date added to LUP
2020-07-30 11:15:41
date last changed
2020-07-31 03:00:09
@article{6367efb8-0577-4563-a32e-4420adf31d14,
  abstract     = {<p>Background: Weighted radiographs are performed to classify acromioclavicular joint dislocations; however, the evidence regarding their usefulness is conflicting. Laboratory studies suggest that internal rotation views can replace weighted radiographs, but this has not been clinically evaluated. Purpose: To evaluate whether weighted or internal rotation radiographs uncovers more high-grade acromioclavicular joint dislocations than non-weighted radiographs. Material and Methods: A total of 162 patients with acromioclavicular joint dislocations were prospectively included. After applying exclusion criteria, 140 remained. Three panorama radiographs, including both coracoclavicular intervals, were completed of each participant: first, a weighted radiograph with 5-kg weights suspended from the wrists; second, a non-weighted radiograph; and third, an internal rotation radiograph. The coracoclavicular intervals were measured by two radiologists independently, and measurements were translated into Rockwood classifications. The classifications and measurements derived from the different radiographic views were compared. Results: Weighted radiographs caused no significant changes in classification. For the internal rotation views, there was a significant change in classification for radiologist 2; however, the reason was that more injuries were downgraded compared to the non-weighted views. Relative to the non-weighted radiographs, the mean increase of the coracoclavicular interval on the injured side in the weighted view was 0.5 mm (95% confidence interval [CI] 0.37–0.65) and in the internal rotation view 0.2 mm (95% CI 0.04–0.33). While these changes were statistically significant, they were small and not clinically important. Conclusion: This study does not support the use of weighted and internal rotation radiographs in the classification of acromioclavicular joint dislocations.</p>},
  author       = {Nordin, Jonas S. and Mogianos, Felicia and Hauggaard, Anders and Lunsjö, Karl},
  issn         = {0284-1851},
  language     = {eng},
  month        = {07},
  publisher    = {SAGE Publications},
  series       = {Acta Radiologica},
  title        = {Weighted or internal rotation radiographs are not useful in the classification of acromioclavicular joint dislocations},
  url          = {http://dx.doi.org/10.1177/0284185120939270},
  doi          = {10.1177/0284185120939270},
  year         = {2020},
}