Common Conditions of the Shoulder

Acromioclavicular Joint (ACJ) Disorders


SLAP Lesion

This joint is located at the end of the clavicle (collar bone) at the top of the shoulder. There are two common conditions affecting this joint.

  1. Dislocation / Subluxation
  2. Arthritis


As with arthritis in other joints of the body this is something which usually affects older people but this is not absolute. Previous injury does not necessarily mean that arthritis will develop.

What are the signs and symptoms?

Pain is felt in the region of the joint. This is usually a dull pain at night, which is made worse by lying on that side. Sharp pain is felt when reaching overhead, particularly at the top of the reach. Symptoms of rotator cuff impingement may also be experienced.

How is the diagnosis made?

The doctor will listen to the description of events and examine the shoulder. X-Rays will also be taken to exclude the shoulder joint as a cause of the problem. Injections of local anaesthetic into the tissues near the joint (the sub-acromial bursa) or the joint itself may be used.

What is the initial treatment?

The initial treatment depends on the symptoms. If the symptoms are purely related to the ACJ an injection of steroid may be beneficial. This may be repeated several times if necessary.

If the symptoms are from both the rotator cuff and the ACJ then steroid injections may be used for both of these sites.

What if the initial treatment fails?

If the symptoms do not improve then it may be necessary to surgically remove the joint. This can be done either through a standard “open” operation or using the arthroscope.

AC Joint Excision