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Table 3 Assessment of horizontal instability

From: The acutely injured acromioclavicular joint – which imaging modalities should be used for accurate diagnosis? A systematic review

Authors Year of publication Study design/level of evidence Number of patients Classification Type of imaging Results (according to classification of Landis / Koch [33])
Schneider et al. [7] 2014 Retrospective case series/IV 58 Rockwood Bilateral panoramic stress and axial views: visual and digitally measured (CCI and HD) classification Digitally measured HD:
IeOR = good to excellent (0.62–0.96)
IaOR = good to excellent (0.67–0.98)
Vaisman et al. [10] 2014 Diagnostic study/II 40 Rockwood Introduction of the AC-width index Width index of ≥60%:
• sensitivity of 95.7% and specificity of 97.5%
• positive predictive value of 96.7% and negative predictive value of 95.6%
for detecting a Rockwood grade IV injury
Tauber et al. [8] 2010 Diagnostic study/II 25 Rockwood Introduction of the GACA Cutoff value of 12.3°:
• sensitivity of 93% and specificity of 92%
• true-negative in 92% and false-negative in 8%
for detecting a Rockwood grade IV injury
Gastaud et al. [9] 2015 Diagnostic study/I 15 Rockwood Bilateral comparative anteroposterior views (Zanca-view4), axial views and dynamic axial views (Tauber8-protocol):
digitally measured (CCI, D/A-ratio, X/Y-ratio, GACA) classification
Digitally measured X/Y-ratio:
IeOR = moderate to good (0.48–0.80)
IaOR = moderate to good (0.49–0.72)
Digitally measured GACA:
IeOR = poor to fair (0.01–0.33)
IaOR = poor to fair (0.09–0.38)
  1. AC-width index = acromioclavicular-width index10, GACA = gleno-acromio-clavicular-angle8, IeOR = inter-observer reliability, IaOR = intraobserver Reliability, HD = horizontal dislocation