Sports Medicine

, Volume 13, Issue 3, pp 214–222 | Cite as

Atraumatic Osteolysis of the Distal Clavicle

A Review
  • Bernard R. Cahill
Injury Clinic


Atraumatic osteolysis of the distal clavicle (AODC) in athletes is a stress failure syndrome of the distal clavicle. It is related to intolerable exercise doses. For some athletes, the acromioclavicular joint is the weak link in their musculoskeletal system. There is never a history of a major injury to the acromioclavicular joint. It occurs principally in young athletes who have a long history of training and performance. It is further characterised by athletes who generally have an associated intense strength training programme.

The condition will inexorably progress to decrease the level of performance and later interfere with activities of daily living.

If the athlete is unwilling to alter his or her exercise training and performance regimen, she or he will eventually become surgical candidates. The results of excision of the distal clavicle for AODC are good or excellent in virtually all cases.

The diagnosis of AODC is confirmed by the history of accumulative exercise doses and the key historical feature of intensive participation in strength training. Local tenderness will be found at the acromioclavicular joint, plain radiographs will show degenerative changes in the vast majority of cases and joint scintigraphy must be positive to confirm the diagnosis.


Strength Training Glenohumeral Joint Impingement Syndrome Acromioclavicular Joint Distal Clavicle 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Allen WC. Post-traumatic osteolysis of the distal clavicle. Postgraduate Medicine 41: A73–A77, 1967PubMedGoogle Scholar
  2. Cahill BR. Osteolysis of the distal part of the clavicle in male athletes. Journal of Bone and Joint Surgery 64A: 1053–1058, 1982Google Scholar
  3. Cook F, Tibone J. The Mumford procedure in athletes: an objective analysis of function. American Journal of Sports Medicine 16: 97–100, 1988PubMedCrossRefGoogle Scholar
  4. DePalma A. Surgery of the shoulder, 3rd ed., pp. 39, J.B. Lippincott, Philadelphia, 1983Google Scholar
  5. Dupas J, Badelon P, Dayde G. Aspects radiologiques d’une Osteolyse essentielle progressive de la main gauche. Journal of Radiology 20: 383–387, 1936Google Scholar
  6. Ehricht HG. Die Osteolyse im lateralen Claviculaende nach Presluftschaden. Archiv für Orthopadische und Unfall-Chirurgie 50: 576–582, 1959PubMedCrossRefGoogle Scholar
  7. Gurd F. The treatment of complete dislocation of the outer end of the clavicle: an hitherto undescribed operation. Annuals of Surgery; 113: 1094–1098, 1941CrossRefGoogle Scholar
  8. Jacobs P. Post-traumatic osteolysis of the outer end of the clavicle. Journal of Bone and Joint Surgery 46B: 705–707, 1964Google Scholar
  9. Lamont MK. Osteolysis of the outer end of the clavicle. New Zealand Medical Journal 95: 241–242, 1982PubMedGoogle Scholar
  10. Levine AH, Paris MJ, Schwartz EE. Posttraumatic osteolysis of the distal clavicle with emphasis on early radiologic changes. American Journal of Roentgenology 127: 781–784, 1976PubMedGoogle Scholar
  11. Madsen B. Osteolysis of the acromial end of the clavicle following trauma. British Journal of Radiology 36: 822–828, 1963PubMedCrossRefGoogle Scholar
  12. Mumford E. Acromioclavicular dislocation. Journal of Bone and Joint Surgery 23: 799–802, 1941Google Scholar
  13. Murphy OB, Bellamy R, Wheeler W, Brower TD. Post-traumatic osteolysis of the distal clavicle. Clinical Orthopaedics 109: 109–114, 1975CrossRefGoogle Scholar
  14. Neer CS. Impingement lesions. Clinical Orthopaedics 173: 70, 1983Google Scholar
  15. Neer CS, Craign E, Fukuda H. Cuff tear arthropathy. Journal of Bone and Joint Surgery; 65A: 1232, 1983Google Scholar
  16. Rockwood C, Green D. Fractures in adults, 2nd ed., JB Lippincott, Philadelphia, 1984Google Scholar
  17. Scavenius M, Iversen B, Sturup J. Resection of the lateral end of the clavicle following osteolysis, with emphasis on nontraumatic osteolysis of the acromial end of the clavicle in athletes. Injury 18: 261–263, 1987PubMedCrossRefGoogle Scholar
  18. Selye H. The physiology and pathology of exposure to stress, ACTA, Inc., Montreal, Canada, 1950.Google Scholar
  19. Seymore EQ. Osteolysis of the clavicular tip associated with repeated minor trauma to the shoulder. Radiology 123: 56, 1977Google Scholar
  20. Smart MJ. Traumatic osteolysis of the distal ends of the clavicles. Journal of the Canadian Association of Radiologists 23: 264–266, 1972PubMedGoogle Scholar
  21. Stahl F. Considerations on post-traumatic absorption of the outer end of the clavicle. Acta Orthopaedica Scandinavica 23: 9–13, 1954Google Scholar
  22. Strauch W. Posttraumatische Osteolysen des lateralen Klavikulaendes. Radiologia Diagnostica 11: 221–229, 1970PubMedGoogle Scholar
  23. Wirth C, Breitner S. Die Resektion des Akromialen Klavikulaendes bei der Schultereckgelenksarthrose. Zeitschrift für Orthopadie und ihre Grenzgebiete 122: 208, 1984PubMedCrossRefGoogle Scholar
  24. Zanca P. Shoulder pain: involvement of the acromioclavicular joint analysis of 1,000 cases. American Journal of Roentgenology 112: 493–506, 1971Google Scholar

Copyright information

© Adis International Limited 1992

Authors and Affiliations

  • Bernard R. Cahill
    • 1
  1. 1.Center for Sports MedicinePeoriaUSA

Personalised recommendations