Description
This is a condition of the joint between the collar bone and the acromion process of the shoulder blade (Scapula). It is often painful by itself. It can lead to impingement on the rotator cuff with secondary damage to the tendon.
Causes
This is based on the specific point tenderness over the joint and can be confirmed by special X-rays of the joint. Bony spurs are seen to project inferiorly from the collar bone or acromion.
Symptoms and signs
Old unreduced dislocations, fractures of the collar bone and aging can lead to arthritis. Cervical spondylosis is also found in this group of patients and the doctor has to clearly differentiate between pain from the neck and the shoulder joint.
Diagnosis
There is pain at the top of the shoulder. This is increased by over head activity. Usually pain from the shoulder is outside the imaginary line of a bra strap unlike neck pain, which is more inward and often radiates to the nape of the neck or chest. There is localized tenderness at the joint. Forcible crossing of the arm by the doctor across the chest leads to increase in pain. Both shoulders are simultaneously affected if the condition is due to aging.
Treatment
Medications involve pain killers. The surgeon may give an injection of steroid into the joint in the clinic. Persistence of symptoms may need excision of the outer half inch of the clavicle(collar bone). This may be done by an open method or through the arthroscope. It may be combined with a subacromial decompression if there is associated impingement leading to a rotator cuff tear.
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