Case | When you hurt your AC joint…

This case is somewhat special… because the patient is my own brother.

Last week my brother had a bad fall while training judo. He fell on his left arm and felt a pretty bad pain on the front part of his shoulder.

It didn’t seem like it was dislocated, but he had pain when he raised his arm. Also, he got a bruise,—which you could see turning yellow/purple-ish through his skin.

Because he thought something was wrong, we took some x-rays— of both his injured shoulder and the healthy one.

Clavicle and AC joint x-ray

Ok, there are no fractures and the shoulder is in its place, but… can you spot what’s wrong? The AC joint is wider on the injured side. That means his ligaments have stretched too much and have probably torn, too.

Clavicle x-ray: healthy vs. injured

I took him for an MRI, to check how his joint was doing.

The MRI showed us several things:

AC joint MRI showing torn ligaments, hemorrhage and increased articular space

  • First, there is bruising around the joint (no surprise, we could even see it through the skin).
  • Also, the AC ligament is torn, which is the reason the space is wider (the AC ligament keeps the acromion and the clavicle together).

There are other ligaments fixing the clavicle: the coracoclavicular ligaments. These are ok, and they are preventing the clavicle from moving upwards. That’s a good thing because when all ligaments are torn, you may end up getting surgery.

MRI of the shoulder showing the coracoclavicular ligaments are ok

All in all, he won’t need surgery. Instead, he must get some rest for a few weeks, avoiding lifting weights and fighting judo. If he has pain, he will take some painkiller such as ibuprofen; also he can apply some ice to reduce the swelling.

So, let’s see how that goes!

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