Distal clavicle osteolysis

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Distal clavicle osteolysis is the painful osseous resorption of the distal clavicle.

Epidemiology

Distal clavicle osteolysis most commonly affects young males. It is bilateral in ~20% .

Pathology

There are two distinct forms of distal clavicle osteolysis although these have identical histopathologic and imaging findings :

  • post-traumatic: weeks to more commonly months after injury
  • atraumatic: stress-induced overuse, seen in laborers and overhead athletes, especially in weight-lifters

Radiographic features

Plain radiograph

May be normal early in the disease course. Progressive disease can manifest with cortical irregularity, subchondral cysts and erosion/tapering of the distal clavicle .

MRI

Bone marrow edema of the distal clavicle more than the acromion with subchondral cystic change +/- subchondral fracture, and distal clavicle periostitis . Acromioclavicular joint effusion and capsular edema may be present .

Differential diagnosis

See article: distal clavicular erosion (differential).