Distal Clavicular Osteolysis in a 20 Year Old Collegiate Football Player
Dr. Kirk Brumels; Professor Meg Frens; Professor Tonia Gruppen
Distal Clavicular Osteolysis (DCO) is a painful deterioration of the distal end of the clavicle. It was first described in 1936 and is characterized as an overuse phenomena that typically occurs in younger athletes with an intense exercise regimen. The frequent training and repetitive stress placed on the Acromioclavicular joint will cause numerous micro-fractures along the clavicle, leading to permanent deterioration of the osseus structures, resulting in resorption of the distal clavicle. The pain will continuously worsen and will be exacerbated by weight training with point tenderness over the AC joint and a decrease in functional activities. Prior to diagnostic imaging, an injection of corticosteroids will be injected into the AC joint. To confirm clinical suspicions of DCO, diagnostic testing will include magnetic resonance imaging (MRI), plain radiographs, and x-rays. Treatment options can be both surgical or non surgical. Non surgical treatment will consist of modifications to weight training and pain modulation. Surgical treatment will include a distal clavicle resection. It may be done with an open incision or an arthroscope. The surgeon will then attach the coracoacromial ligament over the remaining end of the clavicle. ``
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