acromial apophysiolysis apophysitis os acromiale radiology mri shoulder


  • Acromial apophysiolysis or acromial apophysitis is a Stress injury due to repetitive traction injury at the acromial apophysis.


  • It results in instability at the apophysis and shoulder pain.


  • People who have acromial apophysitis have a higher incidence of eventually developing an Os Acromiale.

  • The acromion develops from 3 apophyses which progressively fuse by age 25.

  •  <25yo unfused apophysis is normal but there should be no bone marrow oedema around the apophysis.

  •  If >25yo and apophysis is unfused unfused = Os Acromiale. (Discussed this and how to find it in a previous post you can see HERE

  • The apophysis has to be unfused.
  • Oedema on both sides of the apophysis.
  • +/- Cystic type change and cortical irregularity subjacent to growth plate.

  • It's normal to see an unfused apophysis until 18-25yo.


  • But there should be no oedema, cortical irregularity or subcortical cyst formation.


  • If present, these are signs of instability and apophysiolysis.


See the images below for what the MRI appearance of Acromial Apophysiolisis looks like.

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