Agree with the above - and think it may be possible that in the physical exam, GH capsular restrictions would be found - usually consistent with this type of head/glenoid relationship ("tight" is the best way to describe that) on x-ray.
Joined: February 19, 2004
Yeah, the ACJ space is almost gone and the suprahumeral space is a bit decreased.
That combination would cause subacromial impingement and/or pain on abduction beyond 90 degrees.
Incidentally it looks like there's a little smooth traction spur on the underside of the acromion that suggests an old coracoclavicular ligament injury. That's rugby for you.
By the way, if you look at the very bottom of the second image, in the lung field you'll see a very small round opacity. Some folks might think 'oh no he has a spot on his lung' but it's an example of looking at a vessel on end, kind of like if you took a hose, layed it on a table and xrayed it, then turned the hose so that the opening was facing you and xrayed it again. The horizontally oriented hose would be more radiolucent, but when it was facing you it would look whiter because you're looking at the whole length of the hose. On a lung xray, the second example where it looks whiter (like a 'spot') would simply be described as normal summation of vascular structures.
Joined: March 1, 2004
Large degenerative osteophytes are present at the AC joint with moderate thickening of the distal clavicle suggesting an old healed fracture in secondary post traumatic changes. There appears to be moderate thickening at the distal end of the coracoclavicular ligament attachment suggesting also a prior AC separation that has healed. No definite acute fracture noted.
Joined: February 14, 2003
From: Madison WI USA
Hi Rich, Thanks for your question. Please a look at the description of the purpose of this section of this forum. You will see that we are here for learning only. No patients are harmed during the viewing and hypothesized interpretations of these films by PTs.
Joined: November 15, 2003
PTs have been reading XRays since time immemorial. The greatest value is educating patients who have been scared stiff by a doctor saying "your spine is riddled with arthritis; it will only get worse" or words to that effect.
Understanding what XRs show is useful. It separates the nonthinking technicians from the professionals.