Ara Kassarjian MD, Presenter: Consultant, Arthrosurface, Inc Consultant, Johnson & Johnson (DePuy, Inc)

Eva Llopis MD, Abstract Co-Author: Nothing to Disclose

William Ewing Palmer MD, Abstract Co-Author: Nothing to Disclose

To investigate the association between distal clavicular osteolysis and subchondral fractures of the distal clavicle at MR imaging.

This study was approved by the hospital human research committee, which waived the need for informed consent. Three radiologists retrospectively analyzed 36 shoulder MR examinations in patients with imaging findings of distal clavicular osteolysis. The presence of a subchondral fracture of the distal clavicle, abnormalities of the acromioclavicular joint, rotator cuff tears and labral tears were assessed by MR imaging.

At MR imaging, 31 of 36 patients (86%) had a subchondral line within the distal clavicular edema, consistent with a subchondral fracture. 32 of 36 patients (89%) had fluid in the acromioclavicular joint while 27 of 36 patients (75%) had cysts or erosions in the distal clavicle. 13 patients (36%) had associated labral tears while 8 patients (22%) had partial thickness rotator cuff tears.

A distal clavicular subchondral fracture is a common finding in patients with imaging evidence of distal clavicular osteolysis. These subchondral fractures may be responsible for the propensity of findings occurring on the clavicular side of the acromioclavicular joint.

A subchondral distal clavicular fracture may explain why the bone marrow edema and osseous changes occur more frequently and with greater severity on the clavicular side of the acromioclavicular joint

Kassarjian, A, Llopis, E, Palmer, W, Distal Clavicular Osteolysis: MR Evidence for Subchondral Fracture.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4427884.html