> Acromioclavicular Joint Arthrtis (AC Arthritis)
What is the acromioclavicular joint?
The top, or roof, of
your shoulder blade is called the acromion. Your collarbone,
called the clavicle, connects to the shoulder blade
at the acromioclavicular (AC) joint and to your chest
bone, called the sternum, at the sternoclavicular (SC)
joint. Ligaments, in general, function as joint stabilizers
– attaching at either end to bone. One set of
ligaments help to stabilize the AC joint. Ligamentous
attachments are found both on the distal clavicle and
acromion as well as the prominent coracoid process –
a bony prominence located on the front of the shoulder
blade, or scapula, and directly below the AC joint.
The articulating surfaces of the AC joint are covered
with hyalin cartilage. Bursa sacs and synovial fluid
also help to ensure smooth coordinated movement between
the AC joint, glenohumeral (shoulder) joint and the
under/overlying complex of shoulder tendons.
The term AC Arthritis describes a process of gradual
degeneration in your AC (acromioclavicular) joint that
worsens with wear-and-tear over a period of many years.
Overuse can break down the articular cartilage surfaces,
causing your collarbone and shoulder blade to grind
against each other. This commonly causes the onset of
arthritis in the AC joint. Some weightlifter's develop
a painful AC Joint associated with loss of clavical
bone in the AC Joint. This is called Weightlifter's
Repeated overhead activities are the
most common causes of AC Arthritis.
| Considerations and Treatments
AC Arthritits often can be treated
non-surgically with activity modification, NSAID'S and
a cortisone injection. Surgery usually is not considered
until you have tried non-operative treatment for at
least six months. If your symptoms do not become less
painful, surgery to remove part of your collarbone can
help to restore full function in your shoulder.
| Orthopedic Evaluation
There usually are three parts to an
orthopedic evaluation: medical history, a physical examination,
and tests that your doctor may order.
Your physician likely will ask about
your activities or any traumatic event that may explain
your shoulder pain. You will probably be asked when
the soreness or pain began. If you have had any prior
shoulder injuries, your physician will ask about treatments
you have tried in the past. You will probably be asked
whether you have been able to continue participating
in activities since you noticed the pain. Physicians
also typically ask about other conditions, such as arthritis,
diabetes, and allergies, and medications currently being
taken. You may also be asked about your physical and
athletic goals – information that will help your
physician decide what treatment might be best for you
in achieving those goals.
To diagnose AC Arthritis, physicians usually press the
areas around the front and back of your shoulder to
test for tenderness around the AC (acromioclavicular)
joint. You may be asked to hold your arm up at shoulder
height and move it inward across your chest to test
the stability of the AC joint. You also may be asked
to hold your arms straight out in front of you with
your palms facing down and your hands about six inches
apart. If you experience pain as you resist your physician
pushing your arms down, you may have damage in your
X-rays may be given to check for
fractures and see the position of your collarbone and
shoulder blade. You may be asked to hold weights in
your hands during the X-rays to slightly stress the
AC joint, which provides an image for diagnosing instability.
X-rays can reveal any bone spurs or cysts in your AC