Acromioclavicular Osteoarthritis

Aka: Acromioclavicular Osteoarthritis, Acromioclavicular Arthritis, AC Joint Arthritis

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II. Epidemiology

  1. Common site for arthritic changes

III. Risk Factors: Prior AC Joint Injury

  1. Acromioclavicular Separation
  2. Heavy weight lifting

IV. Symptoms

  1. Pain localizes to the acromioclavicular joint

V. Signs

  1. AC Joint Tenderness to palpation
    1. Absence of tenderness suggests alternative diagnosis
  2. Pain on provocative maneuvers
    1. Shoulder Crossover Maneuver
    2. Endpoint Shoulder Internal Rotation
    3. Shoulder forward flexion

VI. Differential Diagnosis

  1. See Shoulder Pain

VII. Imaging

  1. See Acromioclavicular XRay Findings

VIII. Management

  1. See Osteoarthritis
  2. Modify exacerbating activities
    1. Avoid heavy lifting
    2. Avoid overhead activities
    3. Avoid repetitive Shoulder activities
  3. NSAIDs
  4. Local Corticosteroid Injection at AC joint
    1. Effective for short-term pain relief
    2. Jacob (1997) Biomed Sci Instrum 34:380-5 [PubMed]
  5. Surgery for pain refractory to conservative measures
    1. Distal clavicle resection
    2. Rabalais (2007) Clin Orthop Relat Res 455:30-37 [PubMed]

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