Acromio-clavicular Joint Pathology

Anatomy

The shoulder is a ball and socket joint in the upper extremity that is in part responsible for the positioning of the hand in space. It is made up of the gleno-humeral joint, the acromio-clavicular joint and sternoclavicular joint. These joints are lined with cartilage (gristle) for smooth movement. Like every other joint in the body, the shoulder can suffer from wear and tear of the cartilage – arthritis. This is most commonly observed after middle age and it mainly afflicts the glenohumeral and acromioclavicular parts of the joint.

Causes

Degeneration of the acromio-clavicular joint is almost always a part of the ageing process. Bags and bra straps often pass over this joint and may make the symptoms worse.

Symptoms

This manifests as pain at the top of the shoulder when the arm is elevated and made worse when wearing a bra or carrying a bag on the shoulder. In severe cases the top of the shoulder may hurt at rest. After a history and examination an X-ray is taken which confirms the diagnosis in most cases. Some of the time it isn’t clear despite X-rays and in these cases an MRI scan of the shoulder may be recommended.

Treatment

After a history and examination, the surgeon will perform an X-ray of the shoulder to help confirm the diagnosis. Treatment starts with activity modification (avoiding if possible the actions that cause pain), painkillers and gentle physical therapy as pain allows to maintain shoulder function and strength. If symptoms persist, judicious injections of steroid may be given, though not more than 2 in the same joint in a calendar year. If these measures fail to control symptoms then you and your surgeon should discuss joint replacement surgery.

Foot & Ankle

Hip Pains

Knee

Shoulder

Spine

Lower Back Pain

Paediatric Orthopaedics