Acromioclavicular joint (ACJ) arthrosis is a painful condition that affects the acromioclavicular joint, which is the small joint between the outer end of the clavicle (collar bone) and the acromion(part of the shoulder blade). The joint suffers wear and tear sometimes associated with strenuous use or occasionally after an injury. The condition usually commences with gradual onset of pain in the shoulder. 

Acromioclavicular Joint Oa

How is Acromioclavicular joint arthrosis diagnosed?

A diagnosis of Acromioclavicular joint arthrosis is made based on the history of a painful shoulder. Pain is usually aching in nature and experienced over the top of the shoulder when reaching overhead and across the chest. In some individuals symptoms may be associated with pain from the rotator cuff. Examination shows tenderness over the joint, pain with certain movements of the shoulder and on special acromioclavicular joint tests. An X-ray may demonstrate narrowing of the joint, erosion and formation of spurs. An ultrasound scan may be performed to examine the state of the rotator cuff. Special imaging with a Bone scan or an MRI scan is sometimes necessary.

What is the treatment for Acromioclavicular joint arthrosis?

In the early phase, pain may be controlled with activity modification and the use of pain relieving or anti-inflammatory medication. 

Physiotherapy: You may be advised to see a physiotherapist to treat associated causes of pain or stiffness. Physiotherapy may not help symptoms arising directly from the acromioclavicular joint.

Steroid injection: A steroid injection placed accurately into the acromioclavicular joint will often provide good short to medium term pain relief allowing activities to be undertaken. The injection may be repeated on 2 or 3 occasions at intervals. 

Surgery: If symptoms persist despite adequate nonoperative treatment, it may be appropriate to undertake surgical treatment.  This consists of arthroscopic or “key-hole” surgery to remove some bone from the outer end of the clavicle and the undersurface of the acromion. Following surgery symptoms will usually settle over a period of time.

For further information on surgical treatment, please refer to the section on “Arthroscopic acromioclavicular joint excision”.