Case study: Acromioclavicular joint arthritis – Injection

A 65-year-old female manual laborer presents with a 4-month history of left shoulder pain. She complains of anteromedial shoulder pain exacerbated during external rotation and superior shoulder pain, particularly at night.

Physical examination

• Painful arc present
• Tender acromioclavicular joint
• Scarf test: Positive
• O’Brien’s test: Positive

Imaging

Ultrasound

• Acromioclavicular (AC) joint space narrowing
• Capsular distension
• Osteophyte

Transverse view of the AC joint space showing space narrowing, capsular distension, and an osteophyte.

X-ray

• Rotator cuff arthropathy
• AC joint arthritis

X-ray image of the left shoulder.

Diagnosis

The patient was diagnosed with AC joint arthritis. This condition is caused by deterioration of the cartilage in the AC joint due to frequent stress on the joint, commonly seen in the middle-aged population. Patients usually experience pain and tenderness at the top of the shoulder across the joint.

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