Osteolysis or bone loss is a condition that occurs when the body stops producing enough new bone cells to replace the old bone cells. The distal or end portion of the clavicle or collarbone which forms the AC Joint can get inflamed due to osteolysis setting in over a period of time. Distal clavicle osteolysis that results in shoulder joint pain because of the bone disintegration and damage is most commonly seen in weightlifters or other athletes performing bench presses regularly, in tennis players, swimmers and also among construction workers or military personnel. Though rare, Ddistal Clavicle Osteolysis can also happen from direct trauma to the collarbone during a fall or direct blow.

Distal Clavicle Osteolysis

This condition is normally seen as an overuse injury caused by repeated microfractures that the body attempts to repair. But the remodeling of bone becomes more jagged and uneven with each microfracture. This consequently places undue stress on the end of the clavicle causing deterioration of cartilage on the adjacent AC joint where the clavicle meets the shoulder blade. The causes of Distal Clavicle Osteolysis can be due to a single injury to the AC joint or to the end of the clavicle, minor repetitive injuries to the AC joint or to the end of the clavicle, repetitive stresses on the AC joint, repetitive overhead activities or also because of a pre-existing disease that might affect the mineralization of the bone structure, like rheumatoid arthritis, hyperparathyroidism, infection, multiple myeloma, and scleroderma.

In Distal Clavicle Osteolysis, a sharp or aching pain at the junction of the acromioclavicular joint (AC joint) and collarbone is usually felt during activity, but persistent tenderness around the joint during non-activity or inflammation and swelling are also other symptoms. Reduced strength and reduced mobility can also happen gradually. The diagnosis of this shoulder condition is usually made by physical examination, although imaging tests can also be used to confirm the diagnosis or rule out other causes of shoulder pain. Blood tests are sometimes performed to rule out infection in the bone.

The treatment plan for Distal Clavicle Osteolysis depends on the amount of bone loss. Avoiding or modifying of activities that cause the symptoms along with anti-inflammatory medicines and ice can should allow the clavicle to re-mineralize. The condition may take at least two years to resolve completely and the symptoms could also recur if the earlier activities are restarted. Steroid injections can also give long term pain relief. As for surgical intervention to manage the condition, the most common form of surgery for distal clavicle osteolysis is a distal clavicle resection, or arthroscopic distal clavicle resection, in which the affected portion of the bone is removed. The recovery period for this could be anywhere from one to two weeks.

As for the prevention of Distal Clavicle Osteolysis many athletes may not be able to completely eliminate bench pressing from their weightlifting routine, but some modifications can be made to ease the stress on the joint and collarbone like reducing the hand spacing on the barbell or placing towels on the chest to protect it during the descent phase of the bench press. For those recovering from the condition, work out with the doctor the exercises that can or cannot be done to avoid any further trauma to the AC joint.

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