Distal Clavicle Arthritis and Osteolysis

Distal Clavicle Arthritis (DCA) is one of the most common diseases of the shoulder that generally affects women in the fourth decade of life as a natural consequence of aging or as result of overuse, while Distal Clavicle Osteolysis (DCO) is a relatively rare condition that typically affects younger male and weight lifters secondary to intense repetitive stress or direct trauma at the joint. Radiographs may be very useful at the beginning, and Magnetic Resonance Imaging (MRI) is best exam for detecting both conditions and for long-term follow-up. Pain at Acromioclavicular Joint (ACJ) may be very self-limiting so elimination or reduction of symptom-provocative aspects of patient’s training program or work-related activity is the goal of prevention. Treatment is initially conservative for both conditions since DCO is a self-limited disease and DCA yields excellent results with avoidance of exacerbating activities, physical therapy, Nonsteroidal Anti-inflammatory Drugs (NSAIDs), ice, and passive range of motion exercises. Surgical treatment, meaning Distal Clavicle Excision (DCE), is reserved for those who fail 6–12 months of conservative therapy, but, for athletes, it may be recommended after more than 3 months of attempt and can be performed either arthroscopically or as an open procedure with great results.