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The acromioclavicular joint is a ligamentously and dynamically well stabilized, diarthrodial synovial joint with a tri-intervation. Falling onto the point of the shoulder with the arm adducted across the chest can result in five ligamentous injuries and five types of lateral clavicle fractures. Acromioclavicular joint injuries can also have an insidious onset, reflecting cumulative trauma that limits throwing, bench pressing, and even activities of daily living. A thorough understanding of injections can allow less painful radiographs, afford a more through physical examination, differentiate injuries, and control fracture pain and postoperative pain. We are reaching consensus on radiographic evaluation of the acromioclavicular joint, the status of its surrounding ligaments, and proper treatment. Nonoperative treatment should include an interval program that is functional, practical, and progressive.