AC ARTHRITIS
What is this Acromioclavicular joint in the shoulder?
The Acromioclavicular joint (AC) in the shoulder is where the collar bone (clavicle) articulates or connects to the acromion of the scapula (shoulder bone). The AC joint moves and shifts as the shoulder goes through various motions. Like any other joint in the body the bones of the AC joint are covered with articular cartilage that provides a slick, rubbery surface that allows bones to glide over each other.
What causes degeneration in the acromioclavicular Joint?
The AC joint is a common spot for osteoarthritis to develop in middle age. Since we use out shoulders constantly, the resulting strain can cause degeneration over time. More specifically with repetitive overhead motions. Weightlifters and others who lift heavy amounts of weight overhead tend to have increased incidence of the condition.
AC joint arthritis may also develop as a result of an injury, such as an AC joint separation. This injury is fairly common, and usually results from a fall on the shoulder. Arthritis within the joint may take years to develop and to become symptomatic.
What are common symptoms for patients with acromioclavicular joint arthritis?
Although many patients have signs of ACJ arthritis on x-ray, these findings do not always correlate with symptoms. Many patients may be asymptomatic. Patients with symptomatic arthritis commonly complain of pain and tenderness on the top and front of the shoulder joint, stiffness, and swelling in the joint. The pain is often worse when the arm is brought across the chest, since this motion compresses the joint. Pain can be vague and radiate to the shoulder joint and down the arm, to the front of the chest, or even up to the neck. Patients may also report a clicking or popping sensation. Night pain is often a common complaint.
Treatment
Nonsurgical Treatment
Initial treatment for AC joint arthritis usually consists of rest and anti-inflammatory medications such as aspirin, ibuprofen, or aleve. If pain persists, a cortisone injection into the joint may help. Cortisone’s effects can often be temporary, but it can give very effective relief in the short term.
Surgical Treatment
If conservative treatment fails to relieve pain, surgical intervention is often recommended. The most common procedure for this is a distal clavicle excision, where a small portion of the end of the clavicle is taken off. This is most often done arthroscopically but some cases may require an open incision over the AC joint.
