Acromioclavicular osteoarthritis and shoulder pain: a review of the role of ultrasonography
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REVIEW PAPER
Acromioclavicular osteoarthritis and shoulder pain: a review of the role of ultrasonography Matteo Precerutti1 · Manuela Formica1 · Mara Bonardi2 · Caterina Peroni3 · Francesco Calciati4 Received: 4 June 2020 / Accepted: 12 June 2020 © Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB) 2020
Abstract Acromioclavicular joint osteoarthritis is often a cause of shoulder pain. On the other hand, imaging frequently leads to such a diagnosis, especially in elderly patients, and some authors believe it to have a poor correlation with the clinical picture. It is, however, widely accepted that such a condition can be the cause of rotator cuff impingement. In the case of shoulder pain, it is important to distinguish between symptomatic acromioclavicular osteoarthritis and other causes, especially rotator cuff pathology, which is more common. Sometimes, the clinical picture does not allow for differential diagnosis; in these cases, the injection of a local anesthetic into the acromioclavicular joint or into the subacromial bursa can be of great help. Ultrasonography can easily detect acromioclavicular osteoarthritis and rotator cuff pathology, and it is highly effective in guiding the articular or bursal injection of a local anesthetic to assess the origin of the pain. In addition, in conservative therapy, ultrasonography can guide the articular or bursal injection of corticosteroids and hyaluronic acid. Keywords Acromioclavicular joint · Osteoarthritis · Shoulder · Ultrasonography
Introduction The acromioclavicular (AC) joint is a diarthrodial joint with a limited range of motion, and it is the only articular connection between the axial skeleton and the scapula; osteoarthritis is by far its most common pathology [1]. Some authors [2] point out that there is a poor correlation between imaging evidence of AC osteoarthritis and clinical evidence. The diagnosis of osteoarthritis by imaging (not only with ultrasonography but also with magnetic resonance imaging (MRI), which is the most powerful diagnostic tool for AC osteoarthritis [3]) is much more common than the clinical picture of shoulder pain, especially in elderly patients. Other
* Francesco Calciati [email protected] 1
Servizio Di Diagnostica Per Immagini, ICS Maugeri Spa SB, IRCCS Montescano, Montescano, Italy
2
UO Radiodiagnostica, IRCCS Policlinico S. Matteo Pavia, Pavia, Italy
3
Servizio Di Diagnostica Per Immagini, ICS Maugeri Spa SB, IRCCS Pavia, Pavia, Italy
4
Istituto Di Radiologia, IRCCS Policlinico S. Matteo, Pavia, Italy
authors [4], however, report that AC osteoarthritis is a frequently overlooked cause of shoulder pain. AC joint abnormalities, whether congenital (i.e., os acromiale or hook-shaped acromion) or acquired (i.e., osteoarthritis or post-traumatic changes), have also been widely and unanimously recognized as an important cause of rotator cuff (RC) superior impingement syndrome. Ultrasonography is considered a fully reliable imaging approach for studying RC pathology, and it c
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