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Acromioclavicular joint arthritis of the shoulder

What is the disease?

This is the terminology given to the condition when there is wear and tear of the acromioclavicular joint of the shoulder. As the name describes Acromio clavicular joint is the joint between Acromion (a part of shoulder blade bone) and Clavicle (collar bone). This joint can be easily felt in most of the individuals as it is in the outer edge of the collarbone.  To some extent it contributes to the prominence in the front of the shoulder joint.

Arthritis occurring at acromioclavicular joint can be painful and can restrict number of activities and hence reduces the quality of life .As a person becomes older, normal wear and tear, or degeneration, of the cartilage takes place in the joint. There is a loss of cartilage and, over time, the joint can wear out, become larger, and develop spurs (spiny projections from the bone) around the joint.

What causes it?

It is partly related to the stress on the joint over the course of life.  The condition is more common in individuals doing lot of overhead activities. Often it can coexist with other shoulder problems such as subacromial bursitis.  If there has been an injury to this joint in the past the occurrence of arthritis at a later stage is common. Persons who perform constant overhead lifting, such as is engaged in by weightlifters or construction workers who work overhead, have higher incidence of the disease. Other susceptible individuals are athletes participating in contact sports or engaging in any activity, which may result in a fall on the end of the shoulder. Any blunt force to the shoulder in the course of work, household activities, or accident may cause, over time, arthritis of the acromioclavicular joint.

What are the symptoms/effects?

Similar to arthritis in other joints of the body, there is pain and swelling in the joint as it is used. Overhead activities can be painful.  Pain will limit the sports activity and can impair the quality of life.

How is it diagnosed?

A thorough physical examination and investigation such as an X ray will be needed to confirm the diagnosis

What are the Treatment Options?

Initial treatment involves taking adequate painkillers, resting, then when the pain improves to some extent doing physiotherapy exercises to prevent further stiffness and also to regain the lost movement.  Injection with a steroid into the joint may be helpful for a short period of time.  Occasionally, the injection can give complete relief of pain and there may not be a necessity of further treatment, but often this is not the case and the pain relief usually stays for a short period only.  If these measures fail to improve the pain or if the pain recurs then surgery is the treatment.  The surgery is done arthroscopically and the procedure is called Arthroscopic excision of Acromioclavicular joint.