Osteolysis of the Distal Clavicle: Serial Improvement and Normalization of Acromioclavicular Joint Space with Conservative Care

A, Baby-arm view shoulder radiograph. B, AC joint spot photograph from an A-P external rotation shoulder radiograph. In A, lytic and cystic changes are present involving the distal clavicular cortex, with an intra-articular gas collection in the AC joint (arrow). In B, abnormal widening of the AC joint is noted (arrows).

A, Baby-arm view shoulder radiograph. B, AC joint spot photograph from an A-P external rotation shoulder radiograph. In A, lytic and cystic changes are present involving the distal clavicular cortex, with an intra-articular gas collection in the AC joint (arrow). In B, abnormal widening of the AC joint is noted (arrows).

AC joint spot photograph from an AP external rotation shoulder radiograph taken 7 months later. There is reduction in the number and size of the previously noted subchondral cysts, with interval improvement in the distal clavicular cortical definition. The AC joint width has normalized to 3.0 mm (arrows).

AC joint spot photograph from an AP external rotation shoulder radiograph taken 14 months after the initial study. There is continued interval reduction in the size of the subchondral cysts, with nearly normal cortical consolidation. The AC joint width remains unchanged from the previous examination.