Ultrasound-Guided Cortisone Injections for Acromioclavicular (AC) Joint Injuries at Alton Pain Clinic

 

Introduction to Acromioclavicular (AC) Joint Injuries

An Acromioclavicular (AC) joint injury occurs when there is damage to the joint that connects the clavicle (collarbone) to the acromion (the outermost point of the shoulder blade). This injury often results from a fall, direct trauma, or repetitive stress, and is particularly common in athletes who engage in contact sports or individuals involved in activities requiring overhead motions.

At Alton Pain Clinic, we specialise in providing ultrasound-guided cortisone injections to help reduce inflammation and manage pain in the AC joint. Our team of clinicians is dedicated to offering tailored treatment plans to address the symptoms of AC joint injuries effectively, providing relief for those affected.

Anatomy of the Acromioclavicular (AC) Joint

The AC joint is located at the point where the clavicle (collarbone) meets the acromion, a part of the scapula (shoulder blade). The AC joint plays a crucial role in the movement and stability of the shoulder. It allows for the elevation, depression, and rotation of the shoulder, and it works in conjunction with the sternoclavicular joint and the glenohumeral joint to facilitate a full range of arm movements.

The joint is supported by several ligaments:

  1. Acromioclavicular ligament: This ligament connects the acromion and the clavicle.
  2. Coracoclavicular ligament: This ligament connects the coracoid process of the scapula to the clavicle.
  3. Capsular ligaments: These ligaments surround the joint and provide stability.

Injuries to the AC joint often involve damage to one or more of these ligaments, which can result in pain, instability, and difficulty with shoulder movements.

Causes and Risk Factors for AC Joint Injuries

AC joint injuries are typically caused by trauma or repetitive stress. Common causes include:

  • Falls: A fall onto the shoulder or an outstretched arm can directly impact the AC joint, leading to sprains, strains, or dislocations.
  • Direct impact: Contact sports like rugby, football, and hockey increase the risk of direct trauma to the AC joint.
  • Repetitive overhead movements: Activities such as weightlifting, swimming, and tennis can cause wear and tear on the AC joint, leading to injury over time.
  • Vehicle accidents: A direct blow or impact to the shoulder during a car accident can cause significant damage to the AC joint.

Some risk factors for AC joint injuries include:

  • Age: Older individuals may experience wear and tear of the joint, making it more susceptible to injury.
  • Sporting activity: Athletes involved in contact sports or overhead sports are at an increased risk.
  • Previous injury: Having had a prior AC joint injury can make the joint more vulnerable to re-injury.
  • Repetitive movements: Occupations or hobbies that involve repetitive shoulder motions may strain the AC joint.

Symptoms of Acromioclavicular (AC) Joint Injuries

Symptoms of an AC joint injury can vary depending on the severity of the damage. Common symptoms include:

  • Pain: Pain at the top of the shoulder is a hallmark of AC joint injuries. The pain may be sharp and intense in acute cases or dull and achy in chronic injuries.
  • Swelling: Swelling can occur in the joint due to inflammation, particularly after trauma.
  • Bruising: In more severe cases, bruising around the shoulder and collarbone may be visible.
  • Limited mobility: Difficulty moving the shoulder or lifting the arm overhead is common, particularly with a more severe injury.
  • Deformity: In cases of AC joint dislocation, the clavicle may appear raised or displaced.

In severe cases, the joint may become unstable, leading to the displacement of the clavicle from the acromion, known as a separated shoulder. This type of injury requires prompt attention and can be treated through non-surgical or surgical methods, depending on the severity.

Diagnosing AC Joint Injuries

Diagnosing an AC joint injury typically involves a thorough physical examination by a clinician, including:

  • Palpation: The clinician will feel for tenderness or swelling in the AC joint area.
  • Range of motion testing: The clinician will assess the shoulder’s range of motion and determine if pain is present during movement.

Treatment Options for AC Joint Injuries

Treatment for AC joint injuries depends on the severity of the condition. Options may include:

  • Cortisone injections: In cases where pain and inflammation persist, ultrasound-guided cortisone injections may be used to provide targeted relief.
  • Surgical intervention: Severe cases, such as Grade III or above, may require surgical treatment to stabilise the joint.

Ultrasound-Guided Cortisone Injections for AC Joint Injuries

At Alton Pain Clinic, we offer ultrasound-guided cortisone injections as part of our treatment approach for AC joint injuries. Cortisone, a potent anti-inflammatory medication, can be injected directly into the AC joint to reduce inflammation and manage pain effectively.

How Cortisone Helps with AC Joint Injuries

Cortisone works by suppressing the body’s immune response in the affected area. It inhibits the production of prostaglandins, which are chemicals that promote inflammation and pain. By directly targeting the inflamed tissues in the AC joint, cortisone can provide fast relief from swelling and discomfort, allowing for improved mobility and function of the shoulder.

Mechanism of Action

When injected into the AC joint, cortisone binds to glucocorticoid receptors in the inflamed tissues. This interaction blocks the activation of pro-inflammatory cytokines and enzymes that contribute to tissue damage and pain. Cortisone also inhibits the production of leukotrienes and prostaglandins, which play key roles in the inflammatory process. By reducing the inflammatory response, cortisone provides relief from pain and allows the body to heal more effectively.

The Role of Ultrasound Guidance

Ultrasound guidance ensures that the injection is delivered with precision, targeting the exact site of inflammation. This approach not only enhances the effectiveness of the treatment but also reduces the risk of complications, such as injecting the medication into the wrong area. Ultrasound allows the clinician to visualise the joint in real-time, ensuring accurate placement of the cortisone.

Benefits of Ultrasound-Guided Cortisone Injections

  • Targeted relief: The precision of ultrasound guidance allows for direct injection into the inflamed tissues of the AC joint, providing targeted pain relief.
  • Reduced side effects: By accurately delivering the cortisone to the affected area, the risk of side effects is minimised.
  • Faster recovery: Cortisone injections can help reduce inflammation quickly, facilitating a quicker return to normal activities.

Conclusion

Acromioclavicular (AC) joint injuries can be painful and disruptive, affecting the shoulder’s ability to move freely. At Alton Pain Clinic, we offer ultrasound-guided cortisone injections to effectively manage pain and inflammation in the AC joint. Our team of clinicians is dedicated to providing you with tailored treatment options to support your recovery and enhance your shoulder function.

If you are suffering from an AC joint injury and would like to explore treatment options, contact us at Alton Pain Clinic today. Our expert team will work with you to develop a personalised plan to alleviate your symptoms and improve your quality of life.

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