Question: My general practitioner had discovered that my left acromio-clavicular joint is dislocated. He wrote an order for and x-ray to be performed to include locating the dislocated acromio-clavicular joint. The physician that wrote a finding refused to acknowledge that the clavical is separated from the acromium but, chooses to define that the distal clavical shows a protrusion where the protrusion is the distal clavical is separated from the acromium and declares there is no dislocation. The general practitioner had found and examed the acromio-clavicular joint is dislocated.

I had just read your answer. I was waiting for an email message that you have an answer.
I believe your answer is based on a conservative approach based on the description I gave. I plan to approach the center that performed the the x-ray exams. First of all I did study illustrations of the grades of acromio-clavicular dislocation. I know that I have a a second grad acromio-clavicular dislocation. The illustration is an anatomical diagram of the acromio-clavicular joint including complete tear of the ligament. The illustration also demonstrates the ligament that attaches to the clavicle and to the coracoid process is stretched. I believe this represents the findings the x-ray report states that a 1.2cm x 2.1cm bony protrusion of the mid to distal left clavicle. The findings was written purposely leaving out the detachment of the clavical from the acromium process. the findings also state their are no loss of the integrity of the clavical. Thsi represents that the clavical is intact, it does not have any growth or abnormal build up on it. In essance it was not read to include that the acromium can be seen in the x-ray and the medical provider licensed to read the x-ray purposely left it out.My original complaint and visit to a medical facility was to the emergency room. The emergency room nurse did state that she was ordering an x-ray and then the nurse practioner changed the treatment plan and did not discuss the change to me.

My follow up visit to my general practitioner included the general practitioner discovered my examination the acromio-clavicular dislocation. The x-ray order specifically states x-ray pictures of the acromio-clavicular dislocation.

Thank You Dr. Shubert. I had gone to discuss the findings with the radiology satellite clinic of the hospital. Although, the Radiologist was not present, initially the staff was against the order and did not want the second grade status. I shown my general practitioner had ordered x-ray views because his physical examination gave him a findings from his manual exam the acromioclavicular joint is dislocated. I also checked on whether his exam had placed my first onset under the initial onset date. I believe your view have ne the confidence and restraint to communicate to them. I also accomplished getting direction to obtain a CD of the x-ray images. I am fighting reluctance by medical professionals and technicians. For them to relent XXXXXXX needs has been stressful and a supplemental insurance company denied my claim where my health insurance and another supplemental insurance policy accepted it. I need the proper diagnosis for insurance to pay the orthopedic physician and prescribed treatment. The orthopedic practice currently is not accepting my physician's referral.

Dear Dr. Shubert,
I finally got up enough courage to view the x-ray studies. After looking at all the views, I have discovered that the x-ray views reveal that the dislocation is a grade three according to illustrations I had acquired through the Steadman Clinic website and illustration. The Steadman Clinic is a Sports Medicine & Orthopedic Surgery practice in Vail, XXXXXXX ..

It is your advice that had given me the courage to communicate to the people of the XXXXXXX Medical Center of Warner XXXXXXX XXXXXXX Your advice is correct that the x-ray demonstrates I will need to be seen by an orthopedic surgeon for it.
Sincerely Yours,XXXX
Registered Voter