Case report 752

An 18-year-old woman presented in the Hermann Hospital Trauma Center with a complaint of pain in the left shoulder following a motor vehicle accident in which she was the driver; she had been wearing a seat belt. On physical examination, the left shoulder was free of deformity and swelling, and the range of motion was full. Initial radiographic examination consisted of anteroposterior (AP) views of the left shoulder in both internal and external rotation and an axillary view. Subsequently, erect AP views of the left shoulder, with and without the patient holding a 10pound (4.5kg) weight, were obtained. On the AP view of the left shoulder (Fig. 1) the acromioclavicular joint appeared widened, indicative of grade I acromioclavicular separation. The application of a weight did not produce a change in the acromioclavicular joint (Fig. 2).