A middle aged woman p/w R-shoulder pain after falling on her outstretched arm. You order a plain film to eval for fracture or dislocation. What do you see?

R-shoulder plain film

 

Acromioclavicular (AC) joint separation.

The upper limit of normal is 6-7mm.

Check a plain film of the other shoulder when in doubt about pathology.

Ref: Mennitt K, Hentel K. Emergency Imaging. Emergency Medicine. 2012 April; 44 (4); 15-17.
Image courtesy of: http://www.google.com/imgres?q=AC+joint+separation&hl=en&client=safari&sa=X&rls=en&biw=1367&bih=648&tbm=isch&prmd=imvns&tbnid=bAchMDKBXDAihM:&imgrefurl=http://www.wakeworld.com/forum/showthread.php%3Ft%3D784022&docid=D_l658fdzqx9bM&imgurl=http://www.wakeworld.com/forum/attachment.php%253Fattachmentid%253D9084%2526stc%253D1%2526d%253D1286571524&w=576&h=456&ei=f3WdT82QMqbq0QHc-JDsDg&zoom=1&iact=rc&dur=366&sig=112333941591895744069&page=2&tbnh=143&tbnw=185&start=21&ndsp=24&ved=1t:429,r:12,s:21,i:198&tx=153&ty=7

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