AC Joint Injuries | Diagnosis & Treatments

How does a doctor know my child has an AC joint injury?

Your child's doctor may need a complete medical history in addition to a physical exam, which may include:

  • X-rays: A diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
  • Magnetic Resonance Imaging (MRI): A diagnostic procedure that uses a combination of large magnets, radio frequencies, and a computer to produce detailed images of organs and structures within the body. This test is done to rule out any associated abnormalities of the spinal cord and nerves.

How does a doctor care for arthritis of the AC joint?

  • There is currently no way to replace the cartilage damaged by arthritis.
  • The primary way to control the symptoms of arthritis is to modify your activities so as not to aggravate the condition.
  • Application of ice to the joint helps decrease pain and inflammation.
  • Medication including aspirin, Tylenol, and non-steroidal anti-inflammatory drugs (NSAIDs) are also used commonly.
  • A shot of cortisone in some serious cases.

How does a doctor care for an AC joint separation?

An AC separation can be a very painful injury, so the initial treatment decreases pain.

  • Immobilizing the arm in a sling and placing an ice pack to the shoulder for 20 to 30 minutes every two hours, as needed.
  • NSAIDs can also help the pain.

As the pain starts to subside, it is important to begin moving the fingers, wrist, elbow, and eventually the shoulder in order to prevent a stiff or frozen shoulder.

  • Instruction on when and how much to move the shoulder should be provided by your physician, physical therapist, or trainer.
  • The length of time needed to regain full motion and function depends on the severity or grade of the injury.
  • Recovery from a Grade I AC separation usually takes 10 to 14 days.
  • A Grade III may take six to eight weeks.

When is surgery needed?

When it comes to arthritis, surgery may be indicated if nonsurgical measures fail.

  • Since the pain is due to the ends of the bones making contact with each other, the treatment is removal of a portion of the end of the clavicle.
  • This outpatient surgery can be performed through a small incision about one inch long or arthroscopically using several small incisions.
  • Regardless of the technique used, most patients have full motion by six weeks and return to sports by 12 weeks.

Grade I and II separations rarely require surgery. Even Grade III injuries usually allow a return to full activity with few restrictions. In some cases, a painful lump may persist, necessitating partial clavicle excision in selected individuals (such as high caliber throwing athletes). Surgery can be very successful in these cases, but as always, benefits must be weighed against potential risks.