Acromioclavicular Arthritis and Osteolysis

Acromioclavicular (AC) joint arthritis and osteolysis are common causes of shoulder discomfort. The AC joint is subject to large repetitive loads that can cause symptomatic degenerative pathology. The diagnosis of acromioclavicular joint arthritis or osteolysis is made on a history of localized pain to the AC joint, physical examination positive for tenderness at the AC joint and pain with cross body adduction. The diagnosis is confirmed with x-rays and magnetic resonance imaging if necessary. Conservative treatment with activity modification, physical therapy, and injections should be initially attempted. If nonoperative treatment fails, open or arthroscopic distal clavicle excision is indicated and is successful at relieving symptoms.