From anatomy
Position in the body
The acromion process, or simply acromion, is a bony protrusion on the outside of the top of the human shoulder blade. It is the connecting element between the scapula and the collarbone.
The shoulder complex consists of: scapula; shoulder; collarbone.
A joint is a connection of ligaments and an articular capsule. It is covered with cartilage.
Acromion (lat. Acromion) is a process emerging from the scapula and articulating with the collarbone. The whole thing is called the acromioclavicular joint, which must be in a mobile state.
For this purpose, it has its own structure and elasticity. Similar articulations are present in the hip and elbow joints. However, the mobility is very low, and it belongs to the category of low-moving joints. Without the normal functioning of the acromion, a person will not be able to make a strong swing of the arm.
The shape of the acromion resembles a triangle and an oblong rectangle, flattened on one side. The surface is convex and rough on top, and smooth and concave below. The part on the side is the top point of the shoulder. The deltoid muscle is attached to it. A large surface area under the skin rather than muscle fibers.
The tendons of the deltoid muscle stretch inside the bottom of the acromion, and bundles of the trapezius muscle are attached to the outside.
The uppermost point of the process is smooth and small, called the acromioclavicular joint. This is the place of the ligament of the scapula and clavicle. On the outside of the scapula, on the side under the process, there is a glenoid cavity where the scapula connects to the humerus bone.
The bone structure consists of many ossification points, one of them is the acromion process. It is not uncommon for it to be mistaken for a fragment on an x-ray.
Functionality of the process
The acromial prominence is needed for:
- protecting the joint, nearby muscle tissue, tendons from damage;
- holding the clavicle by the joint capsule and with the help of the acromioclavicular ligament;
- coordination of movements due to a rigid connection that fixes the clavicle to the coracoid process of the scapula. This limits the range of motion, ensures the correct position of the scapula, collarbone and shoulder;
- depreciation and softening of the load on the shoulder joint.
What can harm a joint?
The acromion is a bony protruding formation of a fairly large size, and therefore is susceptible to various types of injuries, unlike other flat scapular areas.
Damage can be associated with various situations.
Partial or complete rupture of ligaments
Often such injuries are the result of a fall on the shoulder or outstretched arm.
The most dangerous activities from this point of view are sports, namely: football, hockey, martial arts.
Most often people go to the emergency room with ligament ruptures in icy conditions.
The symptoms are as follows:
- pain in the shoulder and shoulder girdle;
- swelling in the area of the shoulder girdle.
Dislocations
In this case, the ligament is partially torn, and the scapula does not shift. When a complete rupture occurs, the collarbone moves upward, causing subluxation.
Dislocation occurs when the collarbone moves completely away from the scapula. This happens when the ligaments that prevent the collarbone from moving away from the clavicular process are torn.
Appears:
- pain;
- edema;
- difficulty in movement, namely, the inability to move the arm back or raise it;
- swelling at the collarbone;
- key symptom, that is, when you press on the swelling, there is a feeling of the collarbone dropping down;
- visual shortening of the shoulder girdle as the arm lengthens.
Fractures
Usually the acromion process is broken as a result of a strong blow to the shoulder with the direction of movement from top to bottom. Fractures of this area occur when a person falls on an outstretched or raised upper limb.
You can recognize it by:
- severe pain that increases with hand movement;
- swelling in the affected area;
- the sound of a crunch when pressing on the acromion.
Painful lesion of the acromion process
The acromioclavicular joint is essentially a joint and can become inflamed or undergo degenerative changes of a dystrophic nature in the form of the moments described below.
Arthritis – inflammation of the joint
Appears due to infection of wounds or when an infection develops in the body. Sometimes the culprit is a malfunctioning immune system, rewarding a person with autoimmune inflammation;
Arthrosis – degenerative-dystrophic changes in the joint
At the same time, ligaments may thicken and connective tissues may wear out due to age. But there are situations when the cause of arthrosis is improper treatment of arthritis or injuries.
The symptoms of the disease are as follows:
- pain in the shoulder girdle and joint;
- difficulty moving your hand even at home;
- inflammation, characterized by swelling of the affected joint;
- stiffness;
- chronic fatigue.
At first, the disease hardly manifests itself. Symptoms develop over time until the patient realizes it is time to seek medical help.
There is another problem called impingement or shoulder impingement syndrome. This is a disease of the tendons of the shoulder joint, but due to its close connection with the acromion, it affects it no less. In this case, the person feels pain and is unable to move his shoulder. The reason lies in damage to the rotator cuff.
More often, the pathology occurs in older people, but young people are not immune from this. Impingement syndrome occurs when the acromial process is excessively bent forward, when the acromial ligament is thickened, with changes after injuries, or arthrosis.
There are often cases when rotator cuff damage is a complication not during treatment. To reduce the risk of this pathology, at the first signs of diseases in the acromion area, consult a doctor!
Shoulder impingement syndrome
Impingement (impeachment) - shoulder syndrome is characterized by pain and decreased motor activity in the shoulder joint. The cause of this condition is damage to the rotator cuff, formed by muscle tendons, due to friction against the acromion process, acromial joint and coracoacromial ligament.
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Impingement syndrome can occur not only in the elderly, but also in young people against the background of the following conditions of the acromion process and its articulation:
- excessively bent forward configuration of the acromion;
- thickening of the coracoacromial ligament and joint deformation in chronic injuries and arthrosis.
Thus, damage to the rotator cuff may be a complication of untimely or inadequate treatment of injuries and diseases of the acromion process. A timely visit to a doctor at the first signs of damage to the area of the acromioclavicular joint will help to significantly reduce the risk of such a complication.
Arthrosis of the joints
Degenerative process of a dystrophic nature
Let's take a closer look at the process that appears against the background of age-related changes in the body and when injured.
As soon as the hyaline cartilage changes, arthrosis appears. Friction occurs that is beyond the control of the cartilage, and then pain appears. The cartilage layer wears off, shock absorption decreases and the load on the shoulders increases.
If the joints wear out due to age and aging of a person, the disease is called osteoarthritis. The provoking factor is hard physical work and overload. Loaders, miners, and blacksmiths are most susceptible to this disease. The disease does not spare even young people if the joints are constantly under excessive stress.
It is not difficult to damage a joint. Any blows affect the performance of the bones and often they speed up the onset of arthrosis.
You should always monitor your condition after sprains, bruises, blows, or hematomas. A clavicle fracture requires not only proper therapy, but also compliance with all recommendations during the recovery period in order to eliminate the risk of damage to the joints.
How does arthrosis develop in the acromion?
There are 3 stages of arthrosis development:
, pain appears periodically when moving your hand or when pressing on the collarbone. May radiate to the cervical spine. The initial stage of acromioclavicular arthrosis is mild pain in the collarbone when pressed.
Symptoms are mild- The second one is already more pronounced . The pain intensifies, it is difficult for a person to even get dressed, since the hand physically cannot be moved behind the head. At the same time, a crunching sound is heard. If you try to cross your forearms on your chest, you feel pain.
- The last stage is irreversible . All methods other than surgery do not bring relief.
Diagnostics
It is rarely possible to detect the disease in time due to mild symptoms. The person himself must undergo examinations.
If there are signs of joint damage, the doctor may prescribe a diagnostic blockade, consisting of injections of lidocaine directly into the clavicular joint. What matters is what the patient experiences. If pain was present before the injections and did not go away after, then arthrosis of the acromioclavicular joint can be confidently diagnosed.
But only an x-ray will give an accurate answer.
Treatment
In case of damage
If the collarbone is dislocated, then it must first be put in place. In the most severe cases, surgery may be required to realign the collarbone and repair the ligaments.
If the therapy is carried out correctly, the pain symptoms go away very quickly and do not require further treatment. But, if you suspect an injury to the acromioclavicular joint, you urgently need the help of a doctor.
On the injured side, the arm must be at rest so that the ligaments have the opportunity to recover. For this purpose, bandages and bandages are used.
Important! Old untreated dislocations can cause muscle ossification and the development of arthrosis.
Fractures are treated with an immobilizing bandage if displacement has not occurred. Otherwise, skeletal traction is needed, a surgical intervention in which bone fragments are fastened with a metal structure.
When to start?
As for arthrosis and arthritis, these pathologies need to be treated as early as possible, since the diseases progress. Treatment is carried out comprehensively. Depending on the stage of the pathology, it can be aggressive or mild. Mostly antibiotics, anti-inflammatory non-steroidal and hormonal drugs, painkillers, physiotherapy, therapeutic exercises and massage are prescribed.
In the early stages of arthrosis, steroid injections are not required. The second main role is played by anti-inflammatory drugs for stopping the source of inflammation and pain relief - Diclofenac, Ibuprofen, Xefocam, Voltaren.
Part of the treatment at any stage of the pathology are chondroprotectors that can restore the damaged joint.
The clavicular joint hurts very much when damaged. Injections of steroid drugs are often prescribed - Kenalog, Diprospan, Glucocortisone.
In the most severe cases, surgical intervention and joint replacement are necessary.
