Acromioclavicular (AC) Joint Separation and Arthritis

What is the AC Joint?
The acromioclavicular (AC) joint is where the collarbone (clavicle) meets the top of the shoulder blade (acromion).
What is This Condition?
AC separation: injury to the ligaments holding the clavicle in place, often from a fall onto the shoulder.
AC arthritis: wear-and-tear of the AC joint cartilage, causing pain at the top of the shoulder.
What Causes It?
Separation: direct trauma, usually from sports or falls
Arthritis: gradual breakdown of cartilage from aging, overuse, or after an old injury
What are the Symptoms?
AC Separation:
Sudden pain on top of the shoulder after a fall or impact
Swelling and bruising at the AC joint
A visible bump where the collarbone is raised (in more severe injuries)
Pain with lifting the arm across the body
AC Arthritis:
Aching pain at the top of the shoulder, often worse with overhead lifting or cross-body movements
Tenderness directly over the joint
Stiffness or grinding when moving the shoulder
How is It Diagnosed?
Exam: pain at the top of the shoulder, swelling after injury, or tenderness with direct pressure
X-rays: show separation, arthritis, or joint space narrowing
How is It Treated?
For separations:
Rest, ice, and sling for mild injuries
Physical therapy for recovery
Surgery for severe separations that cause deformity or persistent pain
For arthritis:
Activity modification and NSAIDs
Cortisone injections into the AC joint
Surgery (distal clavicle excision) if pain continues despite non-surgical care
Learn more from AAOS (OrthoInfo):
https://orthoinfo.aaos.org/en/diseases--conditions/shoulder-separation/
