MRI evaluation of coracoclavicular ligament injury in acromioclavicular joint separation

  • Katsumi TakaseEmail author
Original Article



Acromioclavicular joint separation is divided into three types according to Tossy and six types according to Rockwood. However, the trapezoid and conoid ligaments that constitute the coracoclavicular ligaments are not detailed in these classifications. In this study, we investigated the location and degree of ligament injury in acromioclavicular joint separation by means of magnetic resonance (MR) images.

Study designs

Cross-sectional study.


The study subjects were 25 patients (21 men and 4 women) ranging in age from 19 to 58 years (mean: 31.1 years). According to Rockwood’s classification criteria, these patients consisted of one case in type 1, seven cases in type 2, seven cases in type 3, and ten cases in type 5. All patients were also performed the procedure for MR images and enhanced MR images with intravenous gadolinium injection within 3 days after the occurrence of injury.


Both the trapezoid and conoid ligaments had ruptured in fifteen cases of the seventeen cases in types 3 and 5. Both ligaments had ruptured at the same locations in eleven of the fifteen cases. However, there were four cases in which the ligaments had ruptured at different locations. On the other hand, the conoid ligaments did not clearly demonstrate abnormal findings, but the trapezoid ligaments had ruptured in all cases of type 2.


The coracoclavicular ligament injuries evaluated by MR images and enhanced MR images were not always coincident with Rockwood’s classification criteria from plain X-ray films, especially in types 2 and 3 of acromioclavicular joint separation.


Magnetic resonance images Acromioclavicular joint separations Trapezoid ligaments Conoid ligaments 


Conflict of interest

No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. I confirm that the contents of the manuscript have not been published or are not being submitted for publication elsewhere.


  1. 1.
    Antonio GE, Cho JH, Chung CB et al (2003) Pictorial essay. MR imaging appearance and classification of acromioclavicular joint injury. AJR Am J Roentgenol 180(4):1103–1110PubMedGoogle Scholar
  2. 2.
    Barnes CJ, Higgins LD, Major NM et al (2004) Magnetic resonance imaging of the coracoclavicular ligaments: its role in defining pathoanatomy at the acromioclavicular joint. J Surg Orthop Adv 13(2):69–75PubMedGoogle Scholar
  3. 3.
    Bishop JY, Kaeding C (2006) Treatment of the acute traumatic acromioclavicular separation. Sports Med Arthrosc 14(4):237–245PubMedCrossRefGoogle Scholar
  4. 4.
    Fukuda K, Craig EV, An KN et al (1986) Biomechanical study of the ligamentous system of the acromioclavicular joint. J Bone Joint Surg Am 68(3):434–440PubMedGoogle Scholar
  5. 5.
    Mazzocca AD, Spang JT, Rodriguez RR et al (2008) Biomechanical and radiographic analysis of partial coracoclavicular ligament injuries. Am J Sports Med 36(7):1397–1402PubMedCrossRefGoogle Scholar
  6. 6.
    Rockwood CA, Williams GR, Young CD (1996) Injuries to the acromioclavicular joint. In: Rockwood CA, Green DP, Bucholz RW, Heckman JD (eds) Fractures in adults, vol 2, 4th edn. Lippincott-Raven, Philaderphia, pp 1341–1414Google Scholar
  7. 7.
    Schaefer FK, Schaefer PJ, Brossmann J et al (2006) Experimental and clinical evaluation of acromioclavicular joint structures with new scan orientations in MRI. Eur Radiol 16(7):1488–1493PubMedCrossRefGoogle Scholar
  8. 8.
    Simovitch R, Sanders B, Ozbavdar M et al (2009) Acromioclavicular joint injuries: diagnosis and management. J Am Acad Orthop Surg 17(4):207–219PubMedGoogle Scholar
  9. 9.
    Takase K (2010) The coracoclavicular ligaments—an anatomic study-. Surg Radiologic Anat 32(7):683–688CrossRefGoogle Scholar
  10. 10.
    Tossy JD, Mead NC, Sigmond HM (1963) Acromioclavicular separations: useful and practical classification for treatment. Clin Orthop Relat Res 28:111–119PubMedGoogle Scholar
  11. 11.
    Urist MR (1946) Complete dislocations of the acromioclavicular joint: the nature of the traumatic lesion and effective methods of treatment with an analysis of 41 cases. J Bone Joint Surg Am 28(4):813–837PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  1. 1.Department of Orthopedic SurgeryTokyo Medical UniversityTokyoJapan

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