During Week 12 of this NFL season, Washington Redskins tight end Jordan Reed injured his shoulder while attempting to catch a pass in the endzone against the Dallas Cowboys. While Reed continued to finish the first half, he was diagnosed with an AC joint separation at halftime. This posts will give an review of the evaluation and management of AC joint separations in the ED.

Acromioclavicular Joint Separation:

• 9-12% of all shoulder injuries 
• Graded from Mild to Severe
• Rockwood Classification: Types 1-6
• Type 3 is most common (both ligaments torn)
  

Mechanism: Falling on shoulder, or FOOSH

Exam:

• Tenderness over AC joint, may have a deformity 
• Cross body adduction test most sensitive 
• Type 3 gives obvious ‘bump’ on shoulder 

Diagnosis: X-ray of Shoulder

Treatment:

• Type 1 and 2: Immobilize/sling with orthopedic follow up
• Type 3: Generally immobilize/sling but may require surgery
• Type 4-6: Surgical repair
• NSAIDs, Immobilize/Sling for all
• Involve Orthopedics for Type 3-6 at a minimum
• Early shoulder exercises important for optimal functionality