{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T07:48:51Z","timestamp":1777880931025,"version":"3.51.4"},"reference-count":26,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Journal of Sports Medicine"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The severity of acromioclavicular (AC) joint dislocation is evaluated through bilateral anterior-posterior radiographs of the AC joint. AC joint dislocations are graded based on the classification system of Rockwood, which is the foundation for further decision-making regarding therapy regimen.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose\/Hypothesis:<\/jats:title>\n                    <jats:p>The purpose of this study was to simulate technical irregularities in obtaining panoramic views and the effect they might have on the measured coracoclavicular (CC) distance. It was hypothesized that vertical tilt and horizontal rotation of the radiographic panoramic view of the AC joints affect the measured CC distance and, therefore, the Rockwood classification and reliability of the measurement method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Level IV, Diagnosis Study, Case Series.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective analysis including 14 patients with AC joint dislocations and available computed tomography scans of the upper body was conducted. Three-dimensional models of a simulated bilateral panoramic view were tilted and rotated from \u221215\u00b0 to 15\u00b0 in 5\u00b0 increments around the vertical and horizontal axes. Three raters with different experience levels independently measured the CC distance and repeated this process with a minimum 6-week interval. The intra- and interclass correlation coefficients for intra- and interrater reliability were calculated. Changes in CC distance and Rockwood classification due to rotation or tilt were reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The measurements of intra- and interclass correlation coefficients in the neutral (0\u00b0 position) showed a high intra- and interrater reliability (0.878 and 0.952 for intrarater reliability; 0.851 and 0.952 for interrater reliability). By adding vertical tilt and horizontal rotation to simulated panoramic views, the intra- and interreliability of the 3 raters decreased. Vertical tilt showed a higher impact on the measurement reliability than horizontal rotation. In 10 of 14 cases, the initially determined Rockwood classification changed through adding tilt (9\/14) or rotation (5\/14). In 5 cases, the injury was graded more severe. In 3 cases, the classification was changed to a milder grade according to Rockwood. In 2 cases, the injury was changed to a higher or a lower type in the Rockwood classification, respectively, depending on the amount of tilt or rotation. Of the 10 cases that were reclassified by tilt and rotation, 5 were Rockwood type 3 injuries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Vertical tilt and horizontal rotation in simulated panoramic views of the AC joints were demonstrated to have a significant influence on CC distances and Rockwood classification as well as intra- and interrater reliability. This effect was more pronounced with a higher degree of tilt\/rotation. This may affect clinical decision-making, whether to treat this injury nonoperatively or operatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance:<\/jats:title>\n                    <jats:p>The panoramic view is widely used as the gold standard for diagnosing and classifying AC joint dislocations according to Rockwood. Thus, it is a decisive criterion to choose the best treatment. This study investigates the reliability of the radiographic diagnosis of AC joint dislocations when adding tilt and rotation, which may occur in clinical practice while obtaining the panoramic view.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23259671251329344","type":"journal-article","created":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T18:34:06Z","timestamp":1744655646000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Influence of Tilt and Rotation on Coracoclavicular Distance Measurements and Rockwood Classification in Panorama View Radiographs in the Diagnosis of Acromioclavicular Dislocations"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3127-1113","authenticated-orcid":false,"given":"Sophie","family":"Frege","sequence":"first","affiliation":[{"name":"Charit\u00e9-Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin and Berlin Institute of Health, Center for Musculoskeletal Surgery, Berlin, Germany"},{"name":"Department of Hand-, Replantation and Microsurgery, Unfallkrankenhaus Berlin, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucca","family":"Lacheta","sequence":"additional","affiliation":[{"name":"Department of Sports Orthopaedics, Technical University of Munich, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katrin","family":"Karpinski","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedic Surgery, Unfallkrankenhaus Berlin, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alp","family":"Paksoy","sequence":"additional","affiliation":[{"name":"Charit\u00e9-Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin and Berlin Institute of Health, Center for Musculoskeletal Surgery, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Doruk","family":"Akgun","sequence":"additional","affiliation":[{"name":"Charit\u00e9-Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin and Berlin Institute of Health, Center for Musculoskeletal Surgery, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathi","family":"Thiele","sequence":"additional","affiliation":[{"name":"Charit\u00e9-Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin and Berlin Institute of Health, Center for Musculoskeletal Surgery, Berlin, Germany"},{"name":"Auguste Viktoria Krankenhaus Berlin, Center for Shoulder and Elbow Surgery, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sepp","family":"Braun","sequence":"additional","affiliation":[{"name":"Gelenkpunkt, Sports- and Joint Surgery, Innsbruck, Austria"},{"name":"Research Unit for Orthopaedic Sports Medicine and Injury Prevention (OSMI), Private University for Health Sciences, Medical Informatics and Technology, Hall\/Tirol, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Tauber","sequence":"additional","affiliation":[{"name":"Deutsches Schulterzentrum, ATOS Clinic Munich, Munich, Germany"},{"name":"Department of Orthopaedics and Traumatology, Paracelsus Medical University, Salzburg, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philipp","family":"Moroder","sequence":"additional","affiliation":[{"name":"Department for Shoulder and Elbow Surgery, Schulthess Clinic, Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,4,14]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0042-1750726"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v067.i01"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2012.11.023"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2013.11.005"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-022-05935-0"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2014.02.005"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1148\/rg.2020200039"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2015.06.028"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20120919-16"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v082.i13"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2021.01.016"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-020-01934-w"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546506298022"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2020.10.026"},{"key":"e_1_3_2_16_2","unstructured":"MuMIn: multi-model inference. R package version 1.7.2. Published online 2012. Accessed March 13 2025. https:\/\/cran.r-project.org\/package=MuMIn"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-017-1864-y"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2017.09.021"},{"key":"e_1_3_2_19_2","first-page":"483","volume-title":"The Shoulder","author":"Rockwood CA","year":"1998","unstructured":"Rockwood CAJr, Williams GRJr, Young DC. Disorder of the acromioclavicular joint. In: Rockwood CAJr, Matsen FAIII, ed. The Shoulder. 2nd ed. WB Saunders; 1998:483.","edition":"2"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-020-06286-w"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2022.103405"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-014-3436-0"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1177\/23259671231190411"},{"key":"e_1_3_2_24_2","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1097\/00003086-196300280-00012","article-title":"Acromioclavicular separations: useful and practical classification for treatment","volume":"28","author":"Tossy JD","year":"1963","unstructured":"Tossy JD, Mead NC, Sigmond HM. Acromioclavicular separations: useful and practical classification for treatment. Clin Orthop Relat Res. 1963;28:111-119.","journal-title":"Clin Orthop Relat Res"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00193822"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2004.05.042"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.112.3.493"}],"container-title":["Orthopaedic Journal of Sports Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23259671251329344","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/23259671251329344","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23259671251329344","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:27:04Z","timestamp":1777595224000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/23259671251329344"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":26,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1177\/23259671251329344"],"URL":"https:\/\/doi.org\/10.1177\/23259671251329344","relation":{},"ISSN":["2325-9671","2325-9671"],"issn-type":[{"value":"2325-9671","type":"print"},{"value":"2325-9671","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4]]},"article-number":"23259671251329344"}}