Introduction
The acromioclavicular joint, often known as the AC joint, is situated where the shoulder blade and collarbone converge at the top of the shoulder. The AC joint is just one of the numerous tiny plane joints found throughout the body that allow for sliding or gliding motion between articular surfaces. This joint provided the arm with a wide range of motion, enabling the arm to be raised above the head and moved smoothly along the shoulder plane. The acromioclavicular joint's osteoarthritis is a common source of shoulder pain and can be quite debilitating. It is the most prevalent acromioclavicular joint disease and can result from various pathologic causes.
What Is Acromioclavicular Osteoarthritis?
Acromioclavicular osteoarthritis (AO) is a type of osteoarthritis that damages the shoulder. The acromioclavicular joint, or acromion, is where the collarbone joins the bony tip of the shoulder blade and is notably affected. The ends of the bones are bounded by articular cartilage. The bones may readily slide over one another because of the smooth tissue of this form of cartilage. When this cartilage deteriorates, AO sets in because the bones start to rub against one another unevenly. Bone spurs can develop as the bone tries to mend itself as the bones rub against one another. Inflammation, bone spurs, and erratic mobility can all lead to severe pain and range-of-motion loss. Even though AO is less frequent than other forms of osteoarthritis, it is more frequent than the other type of shoulder arthritis, which affects the glenohumeral shoulder joint.
What Is the Function of the Acromioclavicular Joint?
Humans have a wide range of motion in the shoulder, which is a ball-and-socket joint. This wide range comes at the cost of the shoulder being vulnerable to injury. According to a reliable source, up to 67 percent of people will feel shoulder pain during their lifetime, and up to 26 percent will do so right now. Three bones form the shoulder joint:
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Humerus (Upper Arm Bone): The ball of the shoulder joint is made of the humeral head.
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Scapula (Shoulder Blade): The socket of the shoulder joint is made up of the scapula, and several muscles and ligaments support and stabilize the joint capsule.
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Clavicle (Collarbone): An area of the scapula known as the acromion joins to the end of the clavicle. The acromioclavicular ligament, a substantial ligament, connects them. The AC joint is located here.
The AC joint is particularly vulnerable to injury due to its fragile structural makeup. This part accounts for more than 40 percent of shoulder injuries. The range of motion in a healthy AC joint is constrained. The acromion and clavicle end up touching during specific activities, such as raising the arm above the head. The range of motion in the arm can be limited if the joint becomes sore or inflamed.
What Are the Causes and Risk Factors of Acromioclavicular Osteoarthritis?
The main cause of arthritis in the AC joint is the joint's deterioration over time. Between 30 and 50 percent of persons who have an AC joint separation will experience arthritis as a result of their injury. Repetitive stress on the joint, especially from repeated overhead lifting, is the main cause of AC arthritis. AO may be primary or secondary. Primary AO has no known etiology, but it tends to affect adults over 50 more frequently. It also affects women more frequently than it does men. When a condition arises wholly or partially as a result of an underlying issue, it is referred to as secondary AO. The following are risk factors linked to the onset of AC joint arthritis:
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Being over 50 years old.
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Having a history of severe injury or shoulder instability.
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Working in a profession that involves lifting large objects.
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A manual task.
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Sports like weightlifting, basketball, or swimming cause repetitive harm.
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Having an inflammatory form of arthritis, such as psoriatic or rheumatoid.
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Experiencing septic arthritis or a joint capsule infection.
What Are the Symptoms of Acromioclavicular Osteoarthritis?
The signs of AC joint arthritis typically worsen with time and certain movements, such as lifting something overhead or crossing the arms. They frequently consist of the following:
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Pain that occasionally travels into the neck and arm and is located close to the top of the shoulder.
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Restricted range of motion in the shoulder.
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Moving the shoulder with a clicking or snapping sound.
How Is Acromioclavicular Osteoarthritis Diagnosed?
A doctor will inquire about symptoms and medical background as part of the AO diagnostic process. After that, they will do a physical examination. The doctor will evaluate and look for many things throughout the examination, including:
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Muscle strength.
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Mobility or range of motion.
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Tenderness or pain.
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Swelling or enlargement.
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Also, doctors will search for signs of past injuries, inquire about them, or investigate for sounds coming from the joint.
The doctor might then decide to request X-rays based on their results. Images of AO may indicate a narrowing of the joint space, modifications to the bone's morphology, and the development of bone spurs. To help them differentiate between AO and other disorders that can appear similar on scans, such as issues with the rotator cuff, a doctor may occasionally perform ultrasonic imaging.
How Is Acromioclavicular Osteoarthritis Treated?
The majority of injuries may be managed non-surgically, and patients often restore functional movement within six weeks and resume normal activities within 12 weeks.
1. Nonsurgical Therapy:
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Medicine for Inflammation and Pain - The discomfort may be lessened by using painkillers like Tylenol and anti-inflammatory treatments like nonsteroidal anti-inflammatory drugs (NSAIDs). Although these drugs are generally secure, the doctor can offer the greatest guidance on how to utilize them to treat the shoulder. To avoid negative drug interactions or side effects, be certain that the physician is aware of all the medications the patient is taking. Topical anti-inflammatories, such as creams, gels, or patches, may offer relief. Moreover, applying ice or heat might help relax the muscles around the joint or lessen discomfort and swelling.
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Physical Treatment - One might benefit from physical therapy to manage the discomfort, keep an overall range of motion, and develop shoulder strength. Physical therapy may be used to treat any additional shoulder conditions one may have, such as torn rotator cuff muscles, that may be causing that pain.
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Altering Exercising Routines - Pain-producing motions should be avoided to ease discomfort. Exercises that need the arm to cross the body, such as push-ups, overhead lifting, and arm-crossing motions, are particularly prone to hurt.
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Shots of Corticosteroids - Injections of steroids may temporarily lessen swelling and provide pain relief. Moreover, a positive reaction to steroid injections can support the diagnosis. However, these injections are not regarded as a reliable long-term remedy.
2. Surgical Management: If none of these therapies work to relieve the symptoms, then the doctor may suggest surgery. If less invasive treatments are unsuccessful, patients might require distal clavicular excision surgery (DCE). As part of this treatment, the end of the clavicle's bone is removed to create a space between the shoulder blade and collarbone. Since the 1940s, DCE has been used often to treat AC joints. The procedure is now frequently carried out arthroscopically. Using an arthroscope, a long, flexible tube with a camera, surgeons perform arthroscopic surgery. A smaller incision is required when using an arthroscope, and the procedure has a quicker recovery rate.
Conclusion
Shoulder osteoarthritis, or acromioclavicular osteoarthritis, is a prevalent form of arthritis. It forms as a result of thinning cartilage between the acromion and the collarbone. The risk of AO can be increased by injuries, prior dislocations, or torn rotator cuffs. Yet, especially in elderly persons, the illness frequently develops without a clear reason. Although there is no known treatment for AO, there are ways to manage the symptoms and enhance the quality of life. Medication, physical therapy, and surgery are some of these. Anyone with shoulder pain should consult a doctor to diagnose and review their treatment options.
