Distal Clavicle Osteolysis, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

This book describes Distal Clavicle Osteolysis, Diagnosis and Treatment and Related DiseasesDistal clavicle osteolysis is the shoulder joint pain at the end of the clavicle (collarbone) that is the result of bone disintegration and injury. It is an overuse collarbone damage often observed in weightlifters. The most frequent symptom is a sharp or aching pain at the junction of the acromio-clavicular joint (AC joint) and clavicle (collarbone).
While the pain is normally felt during activity, there may also be a continual tenderness around the joint during non-activity. The inflammation and swelling are also frequent presentations. The diagnosis of distal clavicle osteolysis can normally be made by physical examination, even though imaging tests may be done to confirm the diagnosis or exclude other causes of shoulder pain. The good news is that treatment is normally straightforward: RICE rest, ice, compression, elevation, taking an anti-inflammatory and physical therapy.
In some patients, surgery may be required. Distal clavicle osteolysis is produced by repetitive stress and micro-fracture in distal clavicle which also induces osteopeniaIncidenceDistal clavicle osteolysis patients are mainly in their 20s, mainly male, often seen in weightliftersDistal clavicle osteolysis is regarded as an overuse injury produced by repeated micro-fractures that the body attempts to repair.
With each micro-fracture, the remodeling of bone becomes more rough and uneven, producing stress on the end of the clavicle and inducing the deterioration of cartilage on the adjacent AC joint where the clavicle attaches to the shoulder blade. Frequent CausesDistal clavicle osteolysis is observed most often in weightlifters or other athletes who execute heavy bench presses for a long period of time.
Besides weightlifters, anyone who often lifts objects overhead (tennis players, swimmers) and lifts heavy objects (construction workers, military workers) can develop distal clavicle osteolysis. Rarer CausesMuch less often, distal clavicle osteolysis happens from direct trauma to the collarbone, like from a fall or direct blow. The typical pain is located at distal clavicle and anterior superior shoulderIt is gradual in onset.
It is aggravated by repetitive loading (i.e. bench press or push-ups)On physical palpation, there is tenderness felt at the distal end of clavicle and AC jointPhysical ExaminationPain when reaching across the chest is a normal symptom of AC joint disorders. Doctors can confirm this by doing a cross-body adduction test that acts as a provocative testAny pain caused by pressing the arm laterally across the chest is indicated a positive result.
The stability of the AC joint will also be evaluated. This is performed by holding the distal collarbone between the thumb and forefinger and then moving the clavicle (collarbone) in different directions (forward, backward, up, and down), while stabilizing the acromion (a bone projection on the shoulder blade) with the other hand. Similar to AC joint arthritis, the shoulder joint may need to be assessed, as people with distal clavicle osteolysis normally keep a full range of motion of their shoulder.
With a suspected AC joint disorder, the doctor may order an AC injection test, often done under the guidance of a computed tomography (CT) scan. If a person feels temporary pain relief after the steroid is injected, the injection test confirms the diagnosis of AC joint pain. The doctor may also order blood tests, particularly if he suspects a possible infection or that an inflammatory process is going on.
TABLE OF CONTENTIntroductionChapter 1 Distal Clavicle OsteolysisChapter 2 Caus...