Shoulderdoc - Patient information and professional educational material on shoulder and elbow problems
For Treatment or More Information:
01625 545071/2/3
Back Home Up Search


Patient Information
AC joint problems sectionAC joint problems
Biceps Problems sectionBiceps Problems
Calcific Tendinitis sectionCalcific Tendinitis
Frozen Shoulder sectionFrozen Shoulder
Injections sectionInjections
Labral Tears sectionLabral Tears
Nerve Disorders of the Shoulder sectionNerve Disorders of the Shoulder
Pectoralis Major Ruptures sectionPectoralis Major Ruptures
Rotator Cuff Tears sectionRotator Cuff Tears
Shoulder Anatomy sectionShoulder Anatomy
Shoulder Arthritis sectionShoulder Arthritis
Shoulder Arthroscopy sectionShoulder Arthroscopy
Shoulder Dislocations sectionShoulder Dislocations
Shoulder Fractures sectionShoulder Fractures
Shoulder Scans sectionShoulder Scans
Shoulder Sling sectionShoulder Sling
SLAP Lesions sectionSLAP Lesions
Sports Injuries sectionSports Injuries
Subacromial Impingement sectionSubacromial Impingement
Scapula Disorders sectionScapula Disorders
Shoulder Pain sectionShoulder Pain
Sternoclavicular Joint sectionSternoclavicular Joint
Rehabilitation for Shoulders sectionRehabilitation for Shoulders
Condensing Osteitis ClavicleCondensing Osteitis Clavicle
Internal ImpingementInternal Impingement
Os AcromialeOs Acromiale
Shoulder Surgery in ParaplegicsShoulder Surgery in Paraplegics
Aquatic Therapy / HydrotherapyAquatic Therapy / Hydrotherapy
Interactive Anatomy MapInteractive Anatomy Map
Interactive SurgeryInteractive Surgery
Osteochondral Lesions of the ShoulderOsteochondral Lesions of the Shoulder
Propionibacterium acnes InfectionPropionibacterium acnes Infection
Shoulder Clicks, Clunks and PopsShoulder Clicks, Clunks and Pops
Shoulder Surgery BookletShoulder Surgery Booklet

Google Shoulderdoc
[ Advanced Search ]

This website is certified by Health On the Net Foundation. Click to verify. This site complies with the HONcode standard for trustworthy health information: verify here. satisfies the INTUTE criteria for quality and has been awarded 'editor's choice'.

   >>Website last updated: 06 February 2015

Sitemap Sitemap   Print page Print   advanced searchSearch   email articleEmail

Os Acromiale

Authors - Dipankar Bhattacharyya & Lennard Funk

The acromion is the most prominent bone on the top of your shoulder. You can feel it easily. The acromion developes as four separate parts during childhood. These have all joined together (fuse) by the age of 25 years in most people. However, in 8% of people one or more of the parts do not fuse.
The ‘parts’, known as ossification centres are: Preacromion (pa) Mesoacromion (msa) Metacromion (mta)and Basiacromion (ba).

Failure of fusion between  msa and mta is most common but other combinations may be present so that there may  be 7 possible types of Os acromion.

The free fragment is usually one-third of the length of the acromion and includes the acromioclavicular facet and attachments of the coraco-acromial ligaments.(JBJS-B-1993 75-4)

A strong association with rotator cuff tears has been reported  but  is usually a co-condition rather than a causative factor (Act Orth.2000  76-2).

Pain is due to:

  1. Impingement from the unfused fragment bending forward with contraction of the deltoid and ‘traping’ the rotator cuff..
  2. Concomitant rotator cuff tear.
  3. Motion at the unfused site leading to arthritic changes.

This can present exactly like subacromial impingement, with superadded point tenderness.

X-rays are necessary to diagnose the os-acromiale. The best view is the axillary view of the shoulder, although it can be seen on other x-ray views. It can also be seen on MR, ultrasound and CT scans.

Treatment :

Initially:   Physiotherapy, anti-inflammatories and pain-killers

Injections: Depending on the site of pain - subacromial and directly into the unfused, arthritic site. Injections under ultrasound guidance are more accurate, if available.

1. Fixation and Fusion of the unfused segments - Indicated for larger fragments, such as msa, mta and ba.  (J Shoulder Elbow Surg 2004 13-4). This is usually done by an open procedure, but can be done arthroscopically.
2. arthroscopic excision of the unfused fragment (Subacromial decompression) - Indicated for small pre-acromion (pa) only.
a. For more details on the surgery and rehabilitation click here

A tough band of connective tissue that connects two bones to each other. "Ligament" is a fitting term; it comes from the Latin "ligare" meaning "to bind or tie."
'key-hole' surgery. Surgery performed via small incisions, using special instruments and a viewing scope..

Print page Print page    email article Email article

Bookmark this page:

  • google
  • netscape
  • stumbleupon
  • yahoo

Tags: No tags defined for this article. [View tag cloud]

Related Articles

Aquatic Therapy / Hydrotherapy
Lauren Robinson and Annette Turner For more information see
19/10/2014 18:01:39

Aquatic Therapy / Hydrotherapy
Lauren Robinson and Annette Turner For more information see
19/10/2014 18:01:39

Aquatic Therapy / Hydrotherapy
Lauren Robinson and Annette Turner For more information see
19/10/2014 18:01:39

Propionibacterium acnes Infection
Benjamin Kadler, Saurabh Mehta  & Lennard Funk What is P. acnes? P. a...
27/07/2014 18:46:49

Osteochondral Lesions of the Shoulder
Lennard Funk What is it? Osteochondral lesion or osteochondral defect (OCD) i...
01/12/2012 15:11:16

Internal Impingement
What is impingement? The word impingement basically means 'rubbing' or 'catchin...
03/11/2012 13:22:39

Information on Shoulder disorders and injuries. Click on the Menu on the left for...
21/01/2012 18:02:31

Shoulder Clicks, Clunks and Pops
Lennard Funk, 2012 Noises in the joints, such as popping, cracking or clicking...
19/01/2012 22:49:49

Creative Commons Licence The material on this website is designed to support, not replace, the relationship that exists between ourselves and our patients. Full Disclaimer
Manchester Arm Clinic Shoulder fellowships Shoulder Scan Wrightington Upper Limb Unit Website by Blackbox E-Marketing