Osteoarthritis of the acromioclavicular joint

Osteoarthritis of the acromial-clavicular joint is a polyethological disease consisting in the erasure of articular cartilage and intraarticular disc with subsequent changes in bone tissue – osteophytes of the acromion and acromial end of the clavicle with the development of chronic progressive pain syndrome, painful restriction of movements in the shoulder joint associated with narrowing and impingement syndrome in the subacromial space.

The main reason for the development of these changes is sports and professional activity associated with throwing, weight training, and prolonged work with arms raised above the horizontal. On the other hand, an old joint injury, such as a rupture of the acromioclavicular joint with the development of instability, quickly leads to the development of osteoarthritis.

Patients experience localized pain in the projection of the acromioclavicular joint, which increases with movements in the shoulder joint, and night pain may occur, especially in the position on the disturbing side. A clinical examination reveals local soreness when pressing on the acromial end of the clavicle, increased pain when the limb is bent at the shoulder joint (positive cross-chest test). Symptoms of impingement in the subacromial space may also be detected. Diagnostic injection of local anesthetics into the joint cavity, X-ray and MRI make it possible to establish an accurate diagnosis.

Treatment tactics depend on the severity of the complaints, the X-ray and MRI picture. At the first stage, conservative measures are advisable – nonsteroidal anti-inflammatory drugs, physiotherapy and therapeutic gymnastics. In more severe cases, intra-articular administration of glucocorticosteroid drugs is indicated. If conservative therapy is ineffective, surgical treatment is used – arthroscopic subacromial decompression, acromioplasty, excision of the acromial end of the clavicle.