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Osteoarthritis of right acromioclavicular joint — Clinical Guidelines

Overview

Osteoarthritis of the right acromioclavicular (AC) joint involves degenerative changes leading to pain, stiffness, and reduced function in the shoulder region 1.

Diagnosis

Clinical history and physical examination focusing on pain and limited range of motion 1.

Imaging studies such as X-rays to assess joint space narrowing and osteophyte formation 1.

MRI may be used for detailed assessment of soft tissue involvement and early degenerative changes 1.

Management

First-line treatments:

- Nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief and inflammation reduction 2. - Physical therapy focusing on strengthening and flexibility exercises 1.

Adjunctive treatments:

- Intra-articular corticosteroid injections to provide temporary relief 1. - Assistive devices like shoulder immobilizers or slings for symptomatic relief 1.

Special Populations

Pregnancy: Limited specific guidance; NSAIDs should be used cautiously due to potential fetal risks 2.

Elderly: Emphasis on conservative management with careful consideration of comorbidities affecting surgical candidacy 1.

Comorbidities: Presence of other joint diseases may influence treatment choices, favoring non-surgical options 1.

Key Recommendations

Utilize NSAIDs cautiously for pain management, considering potential impacts on soft-tissue healing (Evidence: Moderate 2).

Prioritize conservative management strategies including physical therapy and corticosteroid injections before considering surgical interventions (Evidence: Expert opinion 1).

Employ imaging studies (X-ray, MRI) for accurate diagnosis and assessment of disease progression (Evidence: Expert opinion 1).

References

1 Matzkin E, Rossi MJ. AANA Annual Meeting 2025 Delivers History and Innovation in the Nation's Capital. Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association 2025. link 2 Trasolini NA, Yanke AB, Verma NN, Cole BJ. Safety and Efficacy of Postoperative Nonsteroidal Anti-inflammatory Drugs in Sports Medicine. The Journal of the American Academy of Orthopaedic Surgeons 2022. link 3 Wascher DC. Editorial Commentary: Resident Education: At What Cost?. Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association 2020. link 4 Kekatpure AL, Adikrishna A, Sun JH, Sim GB, Chun JM, Jeon IH. Comparative analysis of visual field and image distortion in 30° and 70° arthroscopes. Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 2016. link 5 Lubowitz JH. Editorial Commentary: Arthroscopic Training and Proficiency Assessment Are Hot Topics. Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association 2015. link 6 Conca M, Taschieri S, Del Fabbro M, Conca R. Inverse knot: a personal sliding knot for arthrosopic surgery. Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 2007. link 7 Grechenig W, Fellinger M, Fankhauser F, Weiglein AH. The Graz learning and training model for arthroscopic surgery. Surgical and radiologic anatomy : SRA 1999. link 8 Zahiri H, Brazina G, Zahiri CA. Arthroscopy language. Orthopaedic review 1994. link 9 Miller WE. Learning arthroscopy. Southern medical journal 1985. link

Osteoarthritis of right acromioclavicular joint