The symptoms of an acromioclavicular joint disorder
The acromioclavicular joint is formed by the distal clavicle and the acromion and held together by a thick capsule. The clavicle is attached to the coracoid process by two strong ligaments. In a fall, these ligaments may be stretched or torn (acromioclavicular joint sprain) and the injury is graded according to its severity. The typical mechanism for AC joint injury is a direct blow or fall on the lateral shoulder with the arm is positioned close to the body. Very frequent in contact sports (hockey, football, rugby) or in bicycle accidents.
Osteoarthritis (and synovitis) of the acromioclavicular joint is not a sign of aging. Many people show evidence of degeneration in their thirties, especially if they are very active physically. It is common in weightlifters (with osteolysis) who do bench presses and in people over 50. Rarely painful, it can be triggered by a fall or exertion, at which point the pain is localized at the top of the shoulder. This is called acute synovitis.
In some cases, the cartilage covering the distal clavicle gradually wears away until it disappears completely, creating bone spurs, or osteophytes. The spurs can form over time, filling the space over the rotator cuff and causing mechanical impingement and the usual symptoms – pain, stiffness, and tearing.
How is it diagnosed?
An simple X-ray of the distal clavicle will detect the disorder. For subtle AC joint sprains, an X-Ray with a weight in the hand will render more obvious the ligament instability. Ultrasound will reveal any swelling (synovitis), cartilage loss and the bone-on-bone aspect of the joint in osteoarthritis. MRI will show both bone and soft tissue abnormality.
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