Does osteolysis of the distal clavicle occur following spinal cord injury?

 Objective. To determine whether there is an association between spinal cord injury and ”atraumatic” osteolysis of the distal clavicle. Patients and design. Seventy-seven consecutive spinal cord injury patients without upper extremity injuries were studied. Of these, 39 each had a pair of chest radiographs – one at admission and one at least 1 month later – which included both acromioclavicular joints. Each radiograph was evaluated by two independent musculoskeletal radiologists, who were masked as to which radiograph was the baseline. Results. Ten of 76 acromioclavicular joints demonstrated osteolysis of the distal clavicle: three bilateral, three left side only, and one right side only. There was one case in which the admission radiograph was read as osteolysis but reverted to normal at 35 months follow-up. Conclusion. There is an apparent association between spinal cord injury and osteolysis of the distal clavicle.