Acromioclavicular Joint

Cure Arthritis Naturally

Cure Arthritis Naturally

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Degenerative change of this joint is primarily related to aging. The disease may start as early as the second decade of life, becoming severe by the fifth decade (de Palma 1957). The disease causes discomfort or pain that may be aggravated by motion, radiating to the upper arm.

Radiography in the early stage shows mild cortical thickening and subcortical osteopenia in the para-articular bones, giving rise to a pencil-line appearance and apparent articular widening (Fig. 9.22A). With the progress of pathological change the articulation becomes narrowed with prominent osteopenia (Fig. 9.23A). The articular change appears to be more prominent in the clavicular side than in the acromial side, and it is indeed peculiar to note that the acromion remains insignificantly affected on radiographs although tracer uptake is intense.

The pinhole scintigraphic findings are the mirror image of the radiographic findings with additional information on altered bone metabolism, featuring varied para-articular uptake and articular obliteration. The extent and intensity of tracer uptake appear to vary according to the severity of degenerative change and arthritic activity. Uptake is mild to moderate and predominantly localized to the clavicular

Mild Joint Degeneration

Fig. 9.22A, B Early acromioclavicular osteoarthritis. A Anteroposterior radiograph of a painful right shoulder in a 39-year-old female shows mild cortical thickening and osteopenia in the para-articular bones (arrowheads), producing the pencil-line sign with apparent articular widening (arrows). B Anterior pinhole scan reveals tracer to characteristically accumulate in the clavicular end (arrowhead) but not in the acromion

Fig. 9.22A, B Early acromioclavicular osteoarthritis. A Anteroposterior radiograph of a painful right shoulder in a 39-year-old female shows mild cortical thickening and osteopenia in the para-articular bones (arrowheads), producing the pencil-line sign with apparent articular widening (arrows). B Anterior pinhole scan reveals tracer to characteristically accumulate in the clavicular end (arrowhead) but not in the acromion end in the early phase when the articular space is relatively preserved (Fig. 9.22B). However, in the active chronic phase with advanced articular narrowing uptake becomes markedly intensified and spreads to the acromion with articular obliteration (Fig. 9.23B). Thus, pinhole scintigraphic analysis shows that degenerative arthritis in the acromioclavicular joint characteristically starts from the clavicular end, at least as far as bone metabolic change is concerned. On occasion, osteophytes are shown by increased tracer uptake. Increased uptake in acromioclavicular osteoarthritis is usually unilateral, and the side involved is related to the side of the hand used most.

Acromioclavicular Joint Space Widening

Fig. 9.23A, B Advanced acromioclavicular osteoarthritis. A Anteroposterior radiograph of a chronic painful right shoulder in a 22-year-old male shows marked narrowing of the lower articular space (arrowheads) with paradoxical widening of the upper compartment due to bony erosion (arrow). B Anterior pinhole scan reveals intense uptake now in both the clavicular end and the acro-mion (arrowheads)

Fig. 9.23A, B Advanced acromioclavicular osteoarthritis. A Anteroposterior radiograph of a chronic painful right shoulder in a 22-year-old male shows marked narrowing of the lower articular space (arrowheads) with paradoxical widening of the upper compartment due to bony erosion (arrow). B Anterior pinhole scan reveals intense uptake now in both the clavicular end and the acro-mion (arrowheads)

Fig. 9.24A, B Chronic osteoarthritis in the glenohumer-al joint. A Anteroposterior radiograph of a painful right shoulder of several years duration in a 48-year-old female shows osteopenia and pencil-line cortex (arrows) in the humeral head and irregular erosion in the glenoid (arrowheads). B Anterior pinhole scan reveals intense uptake in the inferomedial aspect of the humeral head (arrows) and the apposing glenoid (arrowheads)

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Arthritis Joint Pain

Arthritis Joint Pain

Arthritis is a general term which is commonly associated with a number of painful conditions affecting the joints and bones. The term arthritis literally translates to joint inflammation.

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