Posttraumatic osteolysis of the distal clavicle: analysis of 7 cases and a review of the literature.
OBJECTIVE
To discuss the clinical manifestation, radiographic features, and treatment of 7 cases of posttraumatic osteolysis of the distal clavicle. Also, to furnish evidence indicating that the current terminology for this disorder is ambiguous and to propose a new classification system.


METHODS
Three cases resulted from acute trauma, and 4 cases were caused by sports-related repetitive microtrauma. All the cases involved young male patients who had similar clinical presentations that included shoulder pain with decreased shoulder range of motion. Radiographic findings ranged from small erosive changes to aggressive osteolysis of the distal clavicle.


RESULTS
All the patients were treated with conservative care consisting of sling immobilization, ice, various physiotherapeutic modalities, and mobilization exercises. The patients that followed through with care showed clinical improvement within 3 months. Follow-up radiographic examinations, when performed, demonstrated reconstitution of the distal clavicle of various degrees, although lagging behind clinical evidence of improvement.


CONCLUSIONS
Traumatic osteolysis of the distal clavicle may result from acute trauma or repetitive microtrauma. Radiographic changes are varied, including irregularity of the distal clavicle, cystic erosions, and blatant osteolysis. Positive outcomes may be achieved with conservative care; however, patient compliance plays a fundamental role in the overall prognosis.
Mestan
M A
MA
Department of Radiology, Parker College of Chiropractic, Dallas, Tex. 75229-5668, USA. mmestan@parkercc.edu
Bassano
J M
JM
D000328:Adult; D001862:Bone Resorption / Q000150:complications; D002968:Clavicle / Q000000981:diagnostic imaging / Q000293:injuries* / Q000503:physiopathology; D006801:Humans; D008297:Male; D010014:Osteolysis / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D011859:Radiography; D000070599:Shoulder Injuries