Arthrography using an opaque medium to explore the shoulder in two cases demonstrated rupture of the rotator muscles sheath associated with a communication into the acromioclavicular joint. Rupture of the sheath allows direct contact between the humeral head and the capsule of the acromioclavicular joint which becomes eroded progressively. Recent studies have produced data indicating participation of the acromioclavicular joint in the natural history of deteriation of the sheath of the rotator muscles.
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