What are the causes of Distal Clavicle Osteolysis?
Distal Clavicle Osteolysis is thought to be caused by repetitive excess loading on the AC joint during exercises involving horizontal adduction, adduction, internal rotation, and forward/lateral flexion of the shoulder. The movements cause repeated microfractures of the bone, creating an uneven, jagged surface that causes deterioration of cartilage on the AC Joint where it meets the shoulder blade.
Typically, weightlifters experience this injury from frequent overhead lifting exercises or bench pressing. Athletes that participate in overhead movements, such as volleyball, basketball, tennis and swimming can also develop this injury. It is unusual for this injury to occur because of a direct trauma to the shoulder, like from a fall or impact.
What are the symptoms of Distal Clavicle Osteolysis?
A pain at the junction of the AC Joint and the collarbone is normally experienced during activity, often accompanied by inflammation and swelling.
A dull, aching pain sometimes continues after activity, sometimes unilaterally or bilaterally over the distal clavicle and can radiate to the trapezius or the deltoid.
A physical examination can normally give a good indication of condition along with imaging tests for a confirmed diagnosis and to rule out other shoulder conditions. Sometimes blood tests may be ordered to rule out infection of the bone.
Frequently Asked Questions on Distal Clavicle Osteolysis
HOW IS DISTAL CLAVICLE OSTEOLYSIS TREATED?
Initial management of symptoms will be the RICE protocol and anti-inflammatory medication.
If pain and inflammation in the shoulder does not resolve, a London Shoulder Specialists consultant can assess the severity of the damage. Your consultant can advise you on the most appropriate treatment plan, including surgical and non-surgical options, that will give you the best possible outcome. Cortisone injections into the AC Joint may be an option to help relieve pain and to aid the progression of physical therapy.
IS SURGERY REQUIRED FOR DISTAL CLAVICLE OSTEOLYSIS?
Normally, only after non-surgical options have been unsuccessful, surgery may be recommended. An excision of distal clavicle or excision of lateral clavicle or ACJ excision can be performed arthroscopically (via keyhole surgery) as a day case operation.
WHAT IS RECOVERY LIKE AFTER SURGERY?
After surgery, you will normally wear a sling for 24 hours. Physical therapy normally begins within a few days of your procedure to help you regain strength and motion in the shoulder. This will normally last around 3 months. If pain is still experienced in the AC Joint 3 months after surgery, a further steroid injection might be recommended to give relief from any inflamed scar tissue.
If you have further questions about possible treatment options for Distal Clavicle Osteolysis, please arrange a consultation with the London Shoulder Specialists.
