ACROMIOCLAVICULAR (AC) ARTHRITIS                    KANDILNOTES                                                                               

INTRODUCTION

  • Acromioclavicular (AC) Arthritis is one of the most common shoulder pathologies

  • It is characterized by the pinching of the collarbone on the shoulder blade

  • The repetitive motion and transmission of large loads through such a small joint, lead to acceleration of cartilage wear and tear

  • More common in older patients, but can be present in patients in their teens or 20s

  • Significantly higher incidence in weightlifters and other contact athletes

CAUSES

  • Repetitive cross-body and overhead activities can predispose to AC Arthritis

  • Predisposing factors include trauma or history of inflammatory conditions such as rheumatoid arthritis

SIGNS AND SYMPTOMS

  • Pain in the top of the shoulder with certain arm positions, including overhead work and cross-body motions

  • Tenderness over the top of the shoulder, where the shoulder blade meets the collar bone 

  • Prominence or bump in the top of the shoulder, at the AC joint

TREATMENT​​

  • A course of physical therapy or a home exercise program is the mainstay of treatment for AC arthritis. The goal of PT is to strengthen the shoulder girdle 

  • Anti-inflammatories such as ibuprofen may help decrease inflammation from the rotator cuff tendinitis and subacromial bursitis

  • A corticosteroid injection in the subacromial space can locally decrease the inflammation and pain

  • Surgery can be considered if patients fail conservative management. Surgery consists of an arthroscopic shoulder surgery called a mumford procedure. This procedure is minimally invasive and involves debriding the AC joint and removing a portion of the distal clavicle or collarbone to decrease rubbing and pain

PREVENTION

  • Activity modification and avoiding shoulder or arm positions that aggravate the pain

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