{"id":67406,"date":"2026-10-14T22:48:49","date_gmt":"2026-10-15T03:48:49","guid":{"rendered":"https:\/\/osteomag.ca\/?p=67406"},"modified":"2026-10-14T22:48:49","modified_gmt":"2026-10-15T03:48:49","slug":"acromioclavicular-osteoarthritis-symptoms-diagnosis-and-treatment","status":"publish","type":"post","link":"https:\/\/osteomag.ca\/en\/acromioclavicular-osteoarthritis-symptoms-diagnosis-and-treatment\/","title":{"rendered":"Acromioclavicular Osteoarthritis: Symptoms, Diagnosis and Treatment"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_89 counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Table of contents<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #000000;color:#000000\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #000000;color:#000000\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 eztoc-toggle-hide-by-default' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/osteomag.ca\/en\/acromioclavicular-osteoarthritis-symptoms-diagnosis-and-treatment\/#Distinguishing_imaging_changes_from_a_genuinely_painful_joint\" >Distinguishing imaging changes from a genuinely painful joint<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/osteomag.ca\/en\/acromioclavicular-osteoarthritis-symptoms-diagnosis-and-treatment\/#Where_is_the_acromioclavicular_joint\" >Where is the acromioclavicular joint?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/osteomag.ca\/en\/acromioclavicular-osteoarthritis-symptoms-diagnosis-and-treatment\/#Why_does_this_joint_develop_osteoarthritis\" >Why does this joint develop osteoarthritis?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/osteomag.ca\/en\/acromioclavicular-osteoarthritis-symptoms-diagnosis-and-treatment\/#A_common_imaging_finding_that_is_often_silent\" >A common imaging finding that is often silent<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/osteomag.ca\/en\/acromioclavicular-osteoarthritis-symptoms-diagnosis-and-treatment\/#What_are_the_most_typical_symptoms\" >What are the most typical symptoms?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/osteomag.ca\/en\/acromioclavicular-osteoarthritis-symptoms-diagnosis-and-treatment\/#Clinical_examination\" >Clinical examination<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/osteomag.ca\/en\/acromioclavicular-osteoarthritis-symptoms-diagnosis-and-treatment\/#What_do_X-rays_show\" >What do X-rays show?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/osteomag.ca\/en\/acromioclavicular-osteoarthritis-symptoms-diagnosis-and-treatment\/#The_role_of_a_diagnostic_injection\" >The role of a diagnostic injection<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/osteomag.ca\/en\/acromioclavicular-osteoarthritis-symptoms-diagnosis-and-treatment\/#Differential_diagnosis\" >Differential diagnosis<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/osteomag.ca\/en\/acromioclavicular-osteoarthritis-symptoms-diagnosis-and-treatment\/#Conservative_treatment\" >Conservative treatment<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-11\" href=\"https:\/\/osteomag.ca\/en\/acromioclavicular-osteoarthritis-symptoms-diagnosis-and-treatment\/#Temporarily_adapt_irritating_activities\" >Temporarily adapt irritating activities<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-12\" href=\"https:\/\/osteomag.ca\/en\/acromioclavicular-osteoarthritis-symptoms-diagnosis-and-treatment\/#Exercise_and_rehabilitation\" >Exercise and rehabilitation<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-13\" href=\"https:\/\/osteomag.ca\/en\/acromioclavicular-osteoarthritis-symptoms-diagnosis-and-treatment\/#When_is_surgery_considered\" >When is surgery considered?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-14\" href=\"https:\/\/osteomag.ca\/en\/acromioclavicular-osteoarthritis-symptoms-diagnosis-and-treatment\/#What_is_the_role_of_osteopathy\" >What is the role of osteopathy?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-15\" href=\"https:\/\/osteomag.ca\/en\/acromioclavicular-osteoarthritis-symptoms-diagnosis-and-treatment\/#When_should_you_seek_prompt_assessment\" >When should you seek prompt assessment?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-16\" href=\"https:\/\/osteomag.ca\/en\/acromioclavicular-osteoarthritis-symptoms-diagnosis-and-treatment\/#Key_points\" >Key points<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-17\" href=\"https:\/\/osteomag.ca\/en\/acromioclavicular-osteoarthritis-symptoms-diagnosis-and-treatment\/#References\" >References<\/a><\/li><\/ul><\/nav><\/div>\n<div class=\"osteomag-a0\" lang=\"en\">\n<style>.osteomag-a0 img{max-width:100%;height:auto}.osteomag-a0 figure{text-align:center;margin:1.5em auto}.osteomag-a0 figcaption{font-size:.92em;line-height:1.5}.osteomag-a0 table{border-collapse:collapse;width:100%;font-size:.94em;line-height:1.45}.osteomag-a0 td,.osteomag-a0 th{padding:.65em;border:1px solid #ccd4dc;vertical-align:top}.osteomag-a0 th{background:#eef3f7}.osteomag-a0 caption{text-align:left;font-weight:600;margin-bottom:.5em}.osteomag-a0 .osteomag-references{padding-left:1.4em;list-style-type:disc}.osteomag-a0 .osteomag-references li{margin-bottom:.6em;overflow-wrap:anywhere}.osteomag-a0 .osteomag-cite{color:#0869c5!important;text-decoration:underline!important}<\/style>\n<h2><span class=\"ez-toc-section\" id=\"Distinguishing_imaging_changes_from_a_genuinely_painful_joint\"><\/span>Distinguishing imaging changes from a genuinely painful joint<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><strong>Acromioclavicular (AC) joint osteoarthritis<\/strong> refers to degenerative changes in the small joint at the top of the shoulder, between the lateral end of the clavicle and the acromion of the scapula. It is very common on X-rays and MRI, particularly with age, but is not always painful. This is essential: seeing AC osteoarthritis on an image does not automatically mean that this joint is causing the pain.<\/p>\n<p>When symptomatic, AC osteoarthritis typically causes highly localized pain on top of the shoulder, often aggravated by movements that bring the arm across the chest\u2014for example, reaching towards the opposite shoulder, doing push-ups, sleeping on the affected side or performing certain strength-training exercises. Diagnosis therefore depends on agreement between symptoms, clinical examination and imaging\u2014and sometimes a diagnostic injection.<\/p>\n<figure class=\"wp-block-image aligncenter\"><img decoding=\"async\" src=\"https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-36708-1-en.webp\" alt=\"Three educational scenes: the AC joint: imaging and pain.\" width=\"1200\" height=\"675\" class=\"wp-image-67412\" srcset=\"https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-36708-1-en.webp 1200w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-36708-1-en-540x304.webp 540w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-36708-1-en-1030x579.webp 1030w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-36708-1-en-80x45.webp 80w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-36708-1-en-768x432.webp 768w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-36708-1-en-747x420.webp 747w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-36708-1-en-150x84.webp 150w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-36708-1-en-300x169.webp 300w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-36708-1-en-600x338.webp 600w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-36708-1-en-696x392.webp 696w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-36708-1-en-1068x601.webp 1068w\" sizes=\"(max-width: 1200px) 100vw, 1200px\" \/><figcaption>The AC joint: imaging and pain. Educational illustration: these situations are not individual treatment prescriptions.<\/figcaption><\/figure>\n<h2 id=\"h-ou-se-trouve-l-articulation-acromioclaviculaire\" class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Where_is_the_acromioclavicular_joint\"><\/span>Where is the acromioclavicular joint?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>The AC joint connects the outer end of the clavicle to the acromion, the part of the shoulder blade forming the top of the shoulder. It is a small synovial joint that contributes to fine adjustments of the scapula during arm movement.<\/p>\n<p>It does not produce large ranges of motion like the glenohumeral joint, but must allow small rotations and translations so that the scapula can adapt to upper-limb movement. The acromioclavicular capsule and the acromioclavicular and coracoclavicular ligaments stabilize it.<\/p>\n<h2 id=\"h-pourquoi-cette-articulation-developpe-t-elle-de-l-arthrose\" class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Why_does_this_joint_develop_osteoarthritis\"><\/span>Why does this joint develop osteoarthritis?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Like other synovial joints, the AC joint can develop cartilage thinning, subchondral bone remodelling, osteophytes and joint-space narrowing over time. Repeated loading probably plays a role, particularly in activities placing substantial loads on the end of the clavicle.<\/p>\n<p>Previous acromioclavicular trauma can also contribute to post-traumatic osteoarthritis. An old AC sprain or dislocation may alter local mechanics and leave degenerative changes years later. However, a 2024 systematic review of the consequences of previous AC dislocations found that the relationship between the initial treatment and later osteoarthritis remained uncertain.<span> <sup><a class=\"osteomag-cite\" style=\"color:#0869c5!important;text-decoration:underline\" href=\"#ref-36708-en-1\" aria-label=\"Reference 1\">[1]<\/a><\/sup><\/span><\/p>\n<p>In people who do strength training, another condition may resemble osteoarthritis: <strong>distal clavicle osteolysis<\/strong>. It is particularly associated with repeated loading such as bench presses or overhead movements and should be distinguished from primary osteoarthritis.<\/p>\n<h2 id=\"h-un-changement-radiologique-frequent-et-souvent-silencieux\" class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"A_common_imaging_finding_that_is_often_silent\"><\/span>A common imaging finding that is often silent<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>One of the most common errors is attributing pain to osteoarthritis simply because it appears on imaging. A 2022 systematic review showed that signs of AC osteoarthritis are very common in people not seeking care for shoulder pain. In the included studies, approximately 48% of anatomical specimens and up to 70% of asymptomatic shoulders examined by MRI showed changes consistent with AC osteoarthritis.<span> <sup><a class=\"osteomag-cite\" style=\"color:#0869c5!important;text-decoration:underline\" href=\"#ref-36708-en-2\" aria-label=\"Reference 2\">[2]<\/a><\/sup><\/span><\/p>\n<p>Another systematic review published in 2025 confirms that AC joint abnormalities are very common in asymptomatic shoulders. Imaging must therefore always be interpreted alongside the clinical history and examination.<span> <sup><a class=\"osteomag-cite\" style=\"color:#0869c5!important;text-decoration:underline\" href=\"#ref-36708-en-3\" aria-label=\"Reference 3\">[3]<\/a><\/sup><\/span><\/p>\n<h2 id=\"h-quels-sont-les-symptomes-les-plus-typiques\" class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"What_are_the_most_typical_symptoms\"><\/span>What are the most typical symptoms?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>The most suggestive presentation is pain directly on top of the shoulder, over the AC joint. The person can often indicate the painful area with a single finger.<\/p>\n<p>Pain may increase when:<\/p>\n<ul class=\"wp-block-list\">\n<li>bringing the arm across the chest;<\/li>\n<li>carrying a heavy bag on the affected side;<\/li>\n<li>doing push-ups, dips or bench presses;<\/li>\n<li>working for long periods with the arm raised;<\/li>\n<li>sleeping directly on the painful shoulder;<\/li>\n<li>performing repeated pushing or pulling movements.<\/li>\n<\/ul>\n<p>Clicking or cracking may occur, but is not specific. Marked restriction throughout the shoulder&#8217;s range often suggests another coexisting condition, such as adhesive capsulitis or glenohumeral osteoarthritis.<\/p>\n<h2 id=\"h-examen-clinique\" class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Clinical_examination\"><\/span>Clinical examination<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Direct palpation of the joint may reproduce pain. The cross-body adduction test, in which the arm is brought across the chest towards the opposite shoulder, compresses the AC joint and may be painful.<\/p>\n<p>Other tests, such as certain variations of O&#8217;Brien&#8217;s test, may contribute to assessment, but no single clinical test confirms an acromioclavicular source with certainty. Even combinations of tests often change probability only slightly; the full history, examination and context remain necessary.<span> <sup><a class=\"osteomag-cite\" style=\"color:#0869c5!important;text-decoration:underline\" href=\"#ref-36708-en-4\" aria-label=\"Reference 4\">[4]<\/a><\/sup><\/span><span> <sup><a class=\"osteomag-cite\" style=\"color:#0869c5!important;text-decoration:underline\" href=\"#ref-36708-en-5\" aria-label=\"Reference 5\">[5]<\/a><\/sup><\/span><\/p>\n<h2 id=\"h-que-montrent-les-radiographies\" class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"What_do_X-rays_show\"><\/span>What do X-rays show?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>X-rays may show joint-space narrowing, osteophytes, subchondral bone sclerosis or irregularities at the ends of the clavicle and acromion.<\/p>\n<figure class=\"wp-block-image aligncenter is-resized\"><img decoding=\"async\" width=\"600\" height=\"600\" src=\"https:\/\/osteomag.ca\/wp-content\/uploads\/2023\/12\/normal-acromioclavicular-joint.jpg\" alt=\"Normal acromioclavicular joint on a radiograph.\" class=\"wp-image-36709\" style=\"width:464px;height:auto\" srcset=\"https:\/\/osteomag.ca\/wp-content\/uploads\/2023\/12\/normal-acromioclavicular-joint.jpg 600w, https:\/\/osteomag.ca\/wp-content\/uploads\/2023\/12\/normal-acromioclavicular-joint-405x405.jpg 405w, https:\/\/osteomag.ca\/wp-content\/uploads\/2023\/12\/normal-acromioclavicular-joint-80x80.jpg 80w, https:\/\/osteomag.ca\/wp-content\/uploads\/2023\/12\/normal-acromioclavicular-joint-150x150.jpg 150w, https:\/\/osteomag.ca\/wp-content\/uploads\/2023\/12\/normal-acromioclavicular-joint-300x300.jpg 300w\" sizes=\"(max-width: 600px) 100vw, 600px\" \/><figcaption class=\"wp-element-caption\">Radiographic appearance of an AC joint without substantial osteoarthritis. Image: Frank Gaillard, Radiopaedia.org, rID 36288.<\/figcaption><\/figure>\n<figure class=\"wp-block-image aligncenter is-resized\"><img decoding=\"async\" width=\"336\" height=\"336\" src=\"https:\/\/osteomag.ca\/wp-content\/uploads\/2023\/12\/image-33.png\" alt=\"Shoulder radiograph showing acromioclavicular changes.\" class=\"wp-image-36711\" style=\"width:464px;height:auto\" srcset=\"https:\/\/osteomag.ca\/wp-content\/uploads\/2023\/12\/image-33.png 336w, https:\/\/osteomag.ca\/wp-content\/uploads\/2023\/12\/image-33-80x80.png 80w, https:\/\/osteomag.ca\/wp-content\/uploads\/2023\/12\/image-33-150x150.png 150w, https:\/\/osteomag.ca\/wp-content\/uploads\/2023\/12\/image-33-300x300.png 300w\" sizes=\"(max-width: 336px) 100vw, 336px\" \/><figcaption>Retained illustrative radiograph: imaging describes structures but cannot, on its own, establish the source of pain.<\/figcaption><\/figure>\n<p>MRI is not always necessary for uncomplicated AC osteoarthritis. It becomes more useful when symptoms suggest a rotator cuff tear, labral involvement or another source of pain that X-rays cannot clarify.<\/p>\n<div class=\"osteomag-table-wrap\" style=\"overflow-x:auto\">\n<table>\n<caption>Connecting imaging, symptoms and function<\/caption>\n<thead>\n<tr>\n<th scope=\"col\">Element<\/th>\n<th scope=\"col\">Usefulness<\/th>\n<th scope=\"col\">Limitation<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td>Pain on top of the shoulder<\/td>\n<td>Guides the local examination<\/td>\n<td>Does not identify the responsible tissue on its own.<\/td>\n<\/tr>\n<tr>\n<td>Provocation tests<\/td>\n<td>Reproduce certain symptoms<\/td>\n<td>No single test confirms an AC source.<\/td>\n<\/tr>\n<tr>\n<td>X-ray or MRI<\/td>\n<td>Describes structures<\/td>\n<td>Osteoarthritis is often asymptomatic.<\/td>\n<\/tr>\n<tr>\n<td>Tracking meaningful movements<\/td>\n<td>Assesses functional progress<\/td>\n<td>A better image is not necessary for better function.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<figure class=\"wp-block-image aligncenter\"><img decoding=\"async\" src=\"https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-36708-2-en.webp\" alt=\"Three educational scenes: regaining useful shoulder function.\" width=\"1200\" height=\"675\" class=\"wp-image-67415\" srcset=\"https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-36708-2-en.webp 1200w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-36708-2-en-540x304.webp 540w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-36708-2-en-1030x579.webp 1030w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-36708-2-en-80x45.webp 80w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-36708-2-en-768x432.webp 768w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-36708-2-en-747x420.webp 747w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-36708-2-en-150x84.webp 150w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-36708-2-en-300x169.webp 300w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-36708-2-en-600x338.webp 600w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-36708-2-en-696x392.webp 696w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-36708-2-en-1068x601.webp 1068w\" sizes=\"(max-width: 1200px) 100vw, 1200px\" \/><figcaption>Regaining useful shoulder function. Educational illustration: these situations are not individual treatment prescriptions.<\/figcaption><\/figure>\n<h2 id=\"h-le-role-de-l-injection-diagnostique\" class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"The_role_of_a_diagnostic_injection\"><\/span>The role of a diagnostic injection<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>When the diagnosis remains uncertain, a local anaesthetic injection into the AC joint may help determine whether this joint genuinely contributes to the pain. A clear, temporary reduction in pain after the injection strengthens the hypothesis of an acromioclavicular source.<\/p>\n<p>This procedure belongs to an appropriately authorized medical professional. Its response may strengthen a hypothesis, but is neither absolute proof nor a reason to recommend the same procedure for every patient.<\/p>\n<p>This information is particularly useful before considering surgery, because osteoarthritis visible on imaging can be entirely asymptomatic.<span> <sup><a class=\"osteomag-cite\" style=\"color:#0869c5!important;text-decoration:underline\" href=\"#ref-36708-en-6\" aria-label=\"Reference 6\">[6]<\/a><\/sup><\/span><\/p>\n<h2 id=\"h-diagnostic-differentiel\" class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Differential_diagnosis\"><\/span>Differential diagnosis<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Pain on top of or at the front of the shoulder can also arise from other structures. The main possibilities include:<\/p>\n<ul class=\"wp-block-list\">\n<li>rotator cuff tendinopathy or tear;<\/li>\n<li>subacromial pain;<\/li>\n<li>long head of biceps tendinopathy;<\/li>\n<li>adhesive capsulitis;<\/li>\n<li>glenohumeral osteoarthritis;<\/li>\n<li>referred pain from the neck;<\/li>\n<li>an old acromioclavicular sprain;<\/li>\n<li>distal clavicle osteolysis;<\/li>\n<li>less commonly, inflammatory arthritis or joint infection.<\/li>\n<\/ul>\n<p>A complete shoulder and neck examination is therefore generally more useful than an assessment limited to the X-ray.<\/p>\n<h2 id=\"h-traitement-conservateur\" class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Conservative_treatment\"><\/span>Conservative treatment<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Treatment usually begins with non-surgical measures. A 2024 systematic review identified favourable outcomes with several approaches, while emphasizing variable study quality and the absence of one clearly superior strategy.<span> <sup><a class=\"osteomag-cite\" style=\"color:#0869c5!important;text-decoration:underline\" href=\"#ref-36708-en-7\" aria-label=\"Reference 7\">[7]<\/a><\/sup><\/span><\/p>\n<h3 id=\"h-adapter-temporairement-les-activites-irritantes\" class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Temporarily_adapt_irritating_activities\"><\/span>Temporarily adapt irritating activities<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Temporarily reducing movements that strongly compress the joint may help, particularly repeated cross-body movements or certain strength-training exercises. This does not mean immobilizing the shoulder. The aim is to adjust loading while maintaining tolerable activity.<\/p>\n<h3 id=\"h-exercice-et-readaptation\" class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Exercise_and_rehabilitation\"><\/span>Exercise and rehabilitation<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>An exercise programme may target rotator cuff strength, scapular control, shoulder endurance and the ability to perform movements that usually provoke pain. The goal is not to &#8216;create space&#8217; in the joint or erase imaging changes, but to improve functional capacity.<\/p>\n<p>Evidence specific to physiotherapy for AC osteoarthritis remains less extensive than for other shoulder conditions. This supports a pragmatic approach: progressive loading, reducing highly provocative movements and gradual reintroduction according to the patient&#8217;s goals.<span> <sup><a class=\"osteomag-cite\" style=\"color:#0869c5!important;text-decoration:underline\" href=\"#ref-36708-en-8\" aria-label=\"Reference 8\">[8]<\/a><\/sup><\/span><\/p>\n<p>Follow-up can focus on a meaningful task: carrying a light bag, dressing or reaching a shelf. Tolerance is compared across sessions and irritating tasks are gradually reintroduced. A flare-up does not require prolonged immobilization, but unusual pain or substantial loss of function warrants reassessment.<\/p>\n<h2 id=\"h-quand-la-chirurgie-est-elle-envisagee\" class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"When_is_surgery_considered\"><\/span>When is surgery considered?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Surgery is generally reserved for people whose pain remains substantial despite several months of conservative treatment and whose AC joint has been clearly identified as the source of symptoms.<\/p>\n<p>The most common procedure is <strong>distal clavicle excision<\/strong>, also called the Mumford procedure. A small portion of the clavicle is removed to prevent painful contact with the acromion. This can be performed through open or arthroscopic surgery.<span> <sup><a class=\"osteomag-cite\" style=\"color:#0869c5!important;text-decoration:underline\" href=\"#ref-36708-en-9\" aria-label=\"Reference 9\">[9]<\/a><\/sup><\/span><\/p>\n<p>Available studies do not show clear superiority of an open or arthroscopic technique in every case. The decision depends on the surgeon&#8217;s experience, other shoulder lesions and the clinical situation. AC joint arthrodesis is not the usual treatment for primary AC osteoarthritis.<span> <sup><a class=\"osteomag-cite\" style=\"color:#0869c5!important;text-decoration:underline\" href=\"#ref-36708-en-10\" aria-label=\"Reference 10\">[10]<\/a><\/sup><\/span><\/p>\n<h2 id=\"h-quelle-place-pour-l-osteopathie\" class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"What_is_the_role_of_osteopathy\"><\/span>What is the role of osteopathy?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Osteopathy may be used as an <strong>adjunct<\/strong> once the diagnosis has been clarified. Manual treatment may seek to improve shoulder-girdle comfort, thoracic mobility or tolerance in nearby regions to make movement and exercise easier.<\/p>\n<p>Manual care does not remove osteoarthritis, restore cartilage or put the joint back into place. The aim remains comfort and function; evidence specific to AC osteoarthritis does not justify promising lasting effectiveness from osteopathy alone.<\/p>\n<p>Touch and suggested movements respect pain, medical context and the person&#8217;s goals. A very painful region, or one with warmth, redness and fever, needs medical advice first.<\/p>\n<h2 id=\"h-quand-consulter-rapidement\" class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"When_should_you_seek_prompt_assessment\"><\/span>When should you seek prompt assessment?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Prompt assessment is indicated for a new deformity after trauma, sudden inability to raise the arm, marked redness with warmth or fever, substantial unexplained swelling, neurological weakness or severe pain after a fall.<\/p>\n<p>Shoulder pain associated with feeling faint, chest pain, shortness of breath or atypical symptoms must not automatically be attributed to the AC joint.<\/p>\n<h2 id=\"h-a-retenir\" class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Key_points\"><\/span>Key points<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Acromioclavicular osteoarthritis is extremely common on imaging and often asymptomatic. Diagnosing genuinely painful AC osteoarthritis must therefore depend on agreement between symptom location, clinical examination and imaging, sometimes supplemented by a diagnostic injection.<\/p>\n<p>Most people begin with non-surgical care, including activity modification and individualized rehabilitation. Other options require medical discussion. Surgery remains reserved for selected persistent cases; manual treatment does not alter structural degeneration.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"References\"><\/span>References<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<ul class=\"osteomag-references\" style=\"list-style-type:disc\">\n<li id=\"ref-36708-en-1\">[1] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/39226400\/\" target=\"_blank\" rel=\"noopener\">Vossen RJM, Verstift D, Van Etten-Jamaludin FS et al. Choice of Acromioclavicular Dislocation Treatment Should Not Be Influenced by Risk of Development of Acromioclavicular Osteoarthritis: A Systematic Review With Meta-Analysis. JBJS Rev. 2024;12(9):e24.00085. doi:10.2106\/JBJS.RVW.24.00085.<\/a><\/li>\n<li id=\"ref-36708-en-2\">[2] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/35638093\/\" target=\"_blank\" rel=\"noopener\">Rossano A, Manohar N, Veenendaal WJ et al. Prevalence of acromioclavicular joint osteoarthritis in people not seeking care: A systematic review. J Orthop. 2022;32:85-91. doi:10.1016\/j.jor.2022.05.009.<\/a><\/li>\n<li id=\"ref-36708-en-3\">[3] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/39754140\/\" target=\"_blank\" rel=\"noopener\">Ibounig T, R\u00e4m\u00f6 L, Haas R et al. Imaging abnormalities of the acromioclavicular joint and subacromial space are common in asymptomatic shoulders: a systematic review. J Orthop Surg Res. 2025;20(1):7. doi:10.1186\/s13018-024-05378-4.<\/a><\/li>\n<li id=\"ref-36708-en-4\">[4] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/23634871\/\" target=\"_blank\" rel=\"noopener\">Cadogan A, McNair P, Laslett M et al. Shoulder pain in primary care: diagnostic accuracy of clinical examination tests for non-traumatic acromioclavicular joint pain. BMC Musculoskelet Disord. 2013;14:156. doi:10.1186\/1471-2474-14-156.<\/a><\/li>\n<li id=\"ref-36708-en-5\">[5] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/29210329\/\" target=\"_blank\" rel=\"noopener\">Krill MK, Rosas S, Kwon K et al. A concise evidence-based physical examination for diagnosis of acromioclavicular joint pathology: a systematic review. Phys Sportsmed. 2018;46(1):98-104. doi:10.1080\/00913847.2018.1413920.<\/a><\/li>\n<li id=\"ref-36708-en-6\">[6] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/15069148\/\" target=\"_blank\" rel=\"noopener\">Walton J, Mahajan S, Paxinos A et al. Diagnostic values of tests for acromioclavicular joint pain. J Bone Joint Surg Am. 2004;86(4):807-12. doi:10.2106\/00004623-200404000-00021.<\/a><\/li>\n<li id=\"ref-36708-en-7\">[7] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/38655415\/\" target=\"_blank\" rel=\"noopener\">Welch M, Rankin S, How Saw Keng M et al. A systematic review of the treatment of primary acromioclavicular joint osteoarthritis. Shoulder Elbow. 2024;16(2):129-144. doi:10.1177\/17585732231157090.<\/a><\/li>\n<li id=\"ref-36708-en-8\">[8] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/32269599\/\" target=\"_blank\" rel=\"noopener\">Farrell G, Watson L, Devan H. Current evidence for nonpharmacological interventions and criteria for surgical management of persistent acromioclavicular joint osteoarthritis: A systematic review. Shoulder Elbow. 2019;11(6):395-410. doi:10.1177\/1758573219840673.<\/a><\/li>\n<li id=\"ref-36708-en-9\">[9] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/19468890\/\" target=\"_blank\" rel=\"noopener\">Docimo S, Kornitsky D, Futterman B et al. Surgical treatment for acromioclavicular joint osteoarthritis: patient selection, surgical options, complications, and outcome. Curr Rev Musculoskelet Med. 2008;1(2):154-60. doi:10.1007\/s12178-008-9024-5.<\/a><\/li>\n<li id=\"ref-36708-en-10\">[10] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/17159577\/\" target=\"_blank\" rel=\"noopener\">Rabalais RD, McCarty E. Surgical treatment of symptomatic acromioclavicular joint problems: a systematic review. Clin Orthop Relat Res. 2007;455:30-7. doi:10.1097\/BLO.0b013e31802f5450.<\/a><\/li>\n<\/ul>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>AC joint osteoarthritis is common on imaging but not always painful. Understand symptom patterns, clinical assessment, differential diagnosis, rehabilitation and the realistic limits of manual care.<\/p>\n","protected":false},"author":1,"featured_media":36710,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"tdm_status":"","tdm_grid_status":"","footnotes":""},"categories":[157,132],"tags":[],"class_list":["post-67406","post","type-post","status-publish","format-standard","has-post-thumbnail","category-arthrite","category-trouble-de-lepaule"],"amp_enabled":true,"_links":{"self":[{"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/posts\/67406","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/comments?post=67406"}],"version-history":[{"count":2,"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/posts\/67406\/revisions"}],"predecessor-version":[{"id":67456,"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/posts\/67406\/revisions\/67456"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/media\/36710"}],"wp:attachment":[{"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/media?parent=67406"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/categories?post=67406"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/tags?post=67406"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}