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Diagnosis: The x-ray reveals an acromioclavicular (AC) joint separation (Grade II).
AC joint separation is a very common injury in football players and cyclists (fall over handlebars) and caused by a direct blow over the AC joint. Most of these injuries do not require surgery. Pain and instability can last up to 3 months for more severe injuries. Most patients recover with full function of the shoulder. The period of disability and discomfort ranges from a few days to 12 weeks, depending on the severity of the separation. Disruption of the AC joint results in pain and instability in the entire shoulder and arm. The pain is most severe when the patient attempts overhead movements or tries to sleep on the affected side. Surgery can be considered for those whose pain and disability do not resolve within 3 months, for Grade III injuries in competitive athletes, and for those with occupational demands that require repetitive overhead motions.
Acknowledgement: Case presented by Teleradiology Specialists (

Man with blow to shoulder
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