Fractures of the scapula occur infrequently, with a fracture of the acromion being an even rarer entity. Acromial fractures constitute 9% of fractures of the scapula, which amounts to 3–5% of shoulder girdle injuries. Fractures of the acromion are generally secondary to trauma, with only a few cases of stress fracture having been reported. (N Roy, M G Smith, L G H Jacobs, Stress fracture of base of the acromion, Ann Rheum Dis 2002;61:944-945 doi:10.1136/ard.61.10.944)

	This 74 year old lady presented to the Emergency Department after falling and injuring her right shoulder. She was referred for radiography of her right shoulder with a provisional diagnosis of neck of humerus fracture. There is evidence of a fracture of the acromion. Bra hardware noted.
	The lateral scapula projection demonstrates the acromial fracture (arrowed) Bra hardware and Harrington spinal rods noted
	The acromial fracture is also demonstrated on the SI projection. The SI projection provides a good sense of the position of the fracture.
	The acromial fracture is superimposed over the humeral head on the clavicle projection. Necklace and Harrinton spinal rods noted.