Acromioclavicular Joint Roughness
The acromioclavicular joint (AC Joint) is located at the upper end of the shoulder and is the joint that connects the collarbone to the acromion bone (the upper end of the shoulder blade) as shown in the picture below. Acromioclavicular joint roughness is a different condition from shoulder joint roughness (also called the glenohumeral joint) and is more common for the shoulder joint.
The acromioclavicular joint differs from other joints such as the knee joint, hip joint or ankle joint in terms of the rate of movement. It has a small rate of movement, but this small movement must be done with flexibility and smoothness so that the shoulder joint can generally move freely. The acromioclavicular joint is responsible for the upper movements of the shoulder joint such as moving the hand over the head or bringing things from the top drawers. Therefore, the presence of any problems in the acromioclavicular joint may significantly affect the patient's life and daily activities.
Acromioclavicular joint roughness
Causes and symptoms
Most cases of acromioclavicular joint injuries or roughness are due to excessive pressure and effort on the joint during overhead shoulder movements or overhead movements, such as some athletes, weightlifters, and heavy workers. Falls on the shoulder may also cause injury and inflammation of the cartilage, or may cause dislocation of the acromioclavicular joint. As for symptoms:
Pain: In early cases, the symptoms of acromioclavicular joint roughness are limited to pain in the front of the shoulder and the sides of the shoulder, and the pain increases when moving the arm toward the chest, and the source of the pain may be unclear to the patient due to its dispersion between the shoulder, upper chest, and neck.
Protrusion of the upper shoulder: If the patient has previously suffered a joint injury, a protrusion may be noticed in the joint above the shoulder compared to the other unaffected shoulder.
Crackling when moving.
The patient may suffer from acromioclavicular joint roughness without any noticeable symptoms. This is not important.
Diagnosis
Medical history and clinical examination: The patient needs to answer some aspects related to the history of the medical condition, whether he suffers from a previous injury, for example, and the extent to which his condition has affected his daily activities during the previous period of time. The clinical medical examination of the patient is also an essential factor in diagnosing acromioclavicular joint osteoarthritis.
X-rays: The doctor may need to take X-rays of the patient in different positions, which show the extent of narrowing of the acromioclavicular joint and the presence of bony protrusions and growths, which is a sign of acromioclavicular joint degeneration.
Diagnosis of acromioclavicular joint osteoarthritis
Treatment
Conservative non-surgical methods: In the early stages of acromioclavicular joint osteoarthritis, conservative treatment options may be resorted to, including changing the lifestyle by reducing pressure on the affected joint, losing weight, physical therapy, or using anti-inflammatory drugs, painkillers, and other solutions.
Local injections: In cases that do not respond to conservative methods, the joint is usually injected with some anti-inflammatory medications such as cortisone, which relieves pain for a temporary period.
Regenerative therapy: It is one of the latest methods for dealing with cases of joint roughness in general and osteoarthritis of the acromioclavicular joint, and is considered an alternative treatment to temporary local injections such as cortisone injections. This treatment program provides an alternative solution that works to relieve pain, improve movement, and stimulate the restoration of damaged tissues in the joint. This may be done by injecting platelet-rich plasma derived from the patient's blood, or by extracting fat cells rich in stem cells from the patient's own tissue and injecting them into the acromioclavicular joint. The principle of this method depends on stimulating the healing process and self-healing of the damaged cartilage and tissues in the joint, which cannot be achieved through the methods mentioned above. Regenerative therapy is an ideal option for early, intermediate, and some advanced cases, so we recommend that all our patients address the cases before it is too late. Surgical methods: In the case of advanced and severe roughness, as well as in cases where conservative methods fail, surgical treatment is usually arthroscopic, where 5-10 mm of the end of the collarbone is removed, and the bony ends of the joint are smoothed to prevent friction during movement, thus preserving the joint's movement and function without pain. Surgery may be performed in some cases where arthroscopic surgery is not preferred, such as the presence of large upper bone protrusions or the presence of a gelatinous cyst.
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