Acromioclavicular Joint Arthrosis (Osteoarthritis): Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

  • General physical examination – including blood pressure, pulse, body weight, height; further:
    • Inspection (viewing).
      • Skin (normal: intact; abrasions/wounds, redness, hematomas (bruises), scars) and mucous membranes.
      • Gait (fluid, limping).
      • Body or joint posture (upright, bent, gentle posture).
      • Malpositions (deformities, contractures, shortenings).
      • Muscle atrophies (side comparison!, if necessary circumference measurements).
      • Joint (abrasions/wounds, often side comparison swelling (tumor), redness (rubor), hyperthermia (calor); injury indications such as hematoma formation, arthritic joint lumpiness, leg axis assessment).
    • Palpation (palpation) of prominent bone points, tendons, ligaments; musculature; joint (joint effusion); soft tissue swelling; isolated localized tenderness (directly over palpable acromioclavicular joint (acromioclavicular joint))Examination procedure: Beginning medially with the sternoclavicular joint (sternoclavicular joint), followed by clavicle (clavicle), acromioclavicular joint (ACG; AC joint; acromioclavicular joint)) with simultaneous stability testing, then processus coracoideus (coracoid process), sulcus intertubercularis (groove on humerus) and tuberculum majus and minus.
    • Determination of the range of motion of the shoulder joint according to the neutral-zero method both actively and passively in a side-by-side comparison: (Neutral-zero method: the range of motion is given as the maximum deflection of the joint from the neutral position in angular degrees, where the neutral position is designated as 0°. The starting position is the “neutral position”: the person stands upright with the arms hanging down and relaxed, the thumbs pointing forward and the feet parallel. The adjacent angles are defined as the zero position. Standard is that the value away from the body is given first); standard values:

      Comparison measurements with the contralateral joint (side comparison) can reveal even small lateral differences.

    • If necessary, special functional tests:
      • “Painful Arc”: in this case, pain is triggered by active abduction (lateral displacement or spreading of a body part away from the center of the body or the longitudinal axis of an extremity), especially in the range between 60° and 120°. In contrast, passive movements can be painless.
      • Hyperadduction test: The affected arm is jerkily guided towards the center of the body. If the patient feels pain, this speaks for an osteoarthritis of the acromioclavicular joint.
    • Assessment of blood flow, motor function and sensitivity:
      • Circulation (palpation of pulses).
      • Motor function: testing of gross strength in lateral comparison.
      • Sensibility (neurological examination)
  • Health check

Square brackets [ ] indicate possible pathological (pathological) physical findings.