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- Talk
- 15/09/2021
- Canada
The Presence of Additional Pathology in Grade I and II Acromioclavicular Joint Injuries
Description
This presentation features Drew Mulhall, a second-year orthopedic surgery resident at the University of Manitoba, discussing his research on acromioclavicular (AC) joint injuries. He opens with gratitude to the CoA and acknowledges his research support from the Pan Am Clinic Foundation and the Alexander Gibson Fund.
Drew introduces the prevalence of AC joint injuries, which account for approximately 12% of shoulder girdle injuries, particularly common in contact sports and more frequent in males. He explains the classification of these injuries per the Rockwood Classification, focusing specifically on Grade 1 and 2 injuries - where Grade 1 is characterized by a sprain of the AC ligament, and Grade 2 involves a rupture of this ligament and a sprain of the coracoclavicular ligament, alongside slight displacement of the clavicle.
The motivation for his study arose from a clinical case where a patient presented with symptomatic shoulder pain and was ultimately diagnosed with a Grade 2 injury through MRI after initial X-rays failed to show any significant findings. Existing literature indicated that patients with Grade 1 and 2 injuries often experience prolonged symptoms, and many exhibit radiographic signs of degeneration over time.
Drew's research highlights that previous studies did not correlate MRI findings with injury grades or functional outcomes effectively. Thus, his project aimed to identify any additional pathologies present in Grade 1 and 2 AC joint injuries via MRI, compared to traditional X-ray assessments.
He conducted a prospective observational study involving 13 symptomatic patients aged 18 to 65, all diagnosed with Grade 1 or 2 injuries, who underwent MRI within 21 days of injury. Drew notes that 10 patients were found to be diagnostically upgraded, revealing significant underlying pathologies such as muscle injuries, labral tears, and joint effusions.
In summarizing the findings, he emphasized that most study participants were young males involved in sports, with MRIs often revealing more severe injuries than initially classified. This suggests a potential need for revised diagnostic and treatment protocols, possibly advocating for more frequent MRI use in cases of persistent symptoms post-injury.
Drew concludes by outlining future directions for this research, particularly the long-term follow-up of patients to connect functional outcomes with initial MRI findings, paving the way for enhanced clinical understanding and patient care in AC joint injuries. He invites questions from the audience to delve deeper into his findings.