AC joint

My shoulders flared up a month or two ago. I’ve had shoulder issues in the past, but that was pain on use, and weakness related. I did PT and haven’t had any real recurrence.

But this was different. It was clearly inflammation. . . Both shoulders, one worse than the other. I finally got myself in to the orthopedist, and he did X-rays and a full exam. My first question is that he said that it was inflamed, but how can this be known on the basis of an X-ray?

Next question, if you’ve had problems with your AC joint, with joint space narrowing, what has happened over time? He did give me a cortisone shot, with lidocaine, which confirmed that the problem was the AC joint. Clearly, things are worse at the moment, as the cortisone shot was just yesterday.

Good point about the x-ray! Mine was diagnosed with ultrasound. That was nearly two years ago now but was both shoulders with one worse than the other. I had bursitis and impingement as well. The cortisone shot helped immediately, thankfully, as I'd lost all use of my right arm. Over time I'd say that for the first year the slightest over-use would set it off again but it is arguably a joint that has, in this last year, benefited most from the golimumab as well as hydrotherapy exercises.

That said it still feels a very fragile status quo ... I've pushed my new lightweight, cordless vacuum around my kitchen this morning and I know I've done it and my latest physical exam two weeks ago found tenderness all around the shoulder and across the collar bone.

One thing I've found helps with the discomfort at night is having pillows alongside me to resting my arms on if I'm lying on my back or if I'm on the least painful side pulling the pillow into me so that the top arm is supported. Just seems to make a difference having the weight of the arm taken off the shoulder socket.

Good luck Stoney, hope your shot helps in the next day or so.

Thanks Jules. I always love going to surgeons. You know, if the cortisone shot doesn’t work, we can talk surgery. Yeah, I’m not quite there yet.

Actually for shoulders a good old fasioned x-ray is beast (as it is for most arthritis.) On a shoulder film there are 13 points that are examined. (please don't ask me what they are, danged if I can remember) But inflammation is pretty easy to ferret out. Reallyt he only reason to ever do an MRI is to confirm a tear or impingement. There are three check points on the physical exam as well. The US is way behind on ultrasound but rapidly catching up. It could have something to do with the number of ortho centers that have their own MRI not that I'm cynical.

As far as the joint narrowing over time,the space almost disappeared over time with me. and I got shinny new shoulder last year. Getting another prolly this fall if I can make it. I only wish I hadn't waited so long.

Don't discount the possibility of good ol' fashioned bursitis. Its a pretty common thing with PsA. That pain on the top of the AC is usually a dead give away.................

Thanks for the input. The doctor felt very confident it’s the joint, not bursitis, confirmed with the lidocaine and physical exam.

Thankfully the surgical fix, if needed in the future, is simpler than a replacement with the AC joint.