# Acromioclavicular joint dislocation

- Category: chronic
- Review status: reviewed (every claim checked against a document named on this page)
- Sources: Acromioclavicular Joint Injury - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK493188/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class LD48.01 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care
- Verified date: 2026-08

## Verified against

- No dose - referral pathway, no medicine given in primary care
- Acromioclavicular joint dislocation - disease-level clinical article (ac-joint-dislocation-full.txt)

## Treatment metadata

- No drug therapy in primary care (Referral & Advice)

## Complete treatment card

```text
ACROMIOCLAVICULAR JOINT DISLOCATION
Sources: Acromioclavicular Joint Injury - StatPearls - NCBI Bookshelf -
         https://www.ncbi.nlm.nih.gov/books/NBK493188/ · ICPC-3 (WONCA International Classification
         of Primary Care, 3rd edition) class LD48.01 - condition scope only, no dose · No dose -
         referral pathway, no medicine given in primary care
Review status: REVIEWED against No dose - referral pathway, no medicine given in primary care,
               Acromioclavicular joint dislocation - disease-level clinical article
               (ac-joint-dislocation-full.txt)  (2026-08)

IS IT THIS? - reference only, to read alongside your own examination
  SYMPTOMS - what the patient reports (2)
    - Pain over the top of the shoulder follows a fall onto an outstretched arm or a direct blow to
      the shoulder
    - Pain may radiate toward the neck and worsens with movement or lying on the injured side
  SIGNS - what you find (4)
    - Visible swelling, bruising, or deformity may be seen over the AC joint, with tenderness on
      palpation  [bruising · visible deformity]
    - Active and passive shoulder motion may be limited by pain
    - The piano key sign - the clavicle lifts and springs back down when pressed
    - The rest of the clavicle and the sternoclavicular joint should be checked for associated
      injury, plus a neurovascular exam of the arm
  TESTS (5)
    - Plain x-rays are usually enough to diagnose the injury and rule out other causes of shoulder
      pain
    - A Zanca view, an AP film angled 10 to 15 degrees toward the head, can show injuries standard
      views miss
    - Comparing both shoulders on x-ray, or adding weighted stress views, helps clarify an uncertain
      diagnosis
    - Ultrasound or MRI can be used if the diagnosis remains unclear
    - Measuring the coracoclavicular interspace distance against the other shoulder guides treatment
      decisions
  IF NOT THIS - what else fits (5)
    - Distal clavicle osteolysis, AC joint arthritis, or an acromion fracture can mimic this injury
    - Frozen shoulder, anterior subluxation of the humerus, or complex regional pain syndrome are
      alternatives
    - An Erb-Duchenne brachial plexus injury, a labral tear, or an unfused os acromiale should also
      be considered
    - A rotator cuff injury or a superior labral tear can present similarly
    - Septic arthritis of the joint or a true shoulder dislocation are important not to miss
  Source  StatPearls "Acromioclavicular Joint Injury" - disease-level clinical article
  Status  traced to the source above

1. NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)    [1st line]
   Adult    AC joint injury from a fall onto the shoulder or a direct blow; low-grade injuries are
            managed with a sling and analgesia, higher-grade separations need orthopedic referral. -
            Refer, with advice
   Peds     Children follow the same pathway: recognise and refer. No primary-care medicine is
            implied.
   Source   No dose - referral pathway, no medicine given in primary care
   Why      AC joint injury from a fall onto the shoulder or a direct blow; low-grade injuries are
            managed with a sling and analgesia, higher-grade separations need orthopedic referral.
   Caution  Marked deformity or skin tenting over the joint, neurovascular injury, high-grade
            separation.
            No medicine is prescribed for this in primary care - this entry is for recognition and
            referral. Anything given is decided by the service it is referred to.
            RED FLAG - Evaluate for associated clavicle fracture, sternoclavicular injury, or
            neurovascular insult on the affected extremity.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.
```

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