Osteolysis Of The Distal Clavicle - Everything You Need To Know - Dr. Nabil Ebraheim скачать в хорошем качестве

Osteolysis Of The Distal Clavicle - Everything You Need To Know - Dr. Nabil Ebraheim

Dr. Ebraheim’s educational animated video describes the condition of osteolysis of the distal clavic Dr. Ebraheim’s educational animated video describes Distal Clavicle Osteolysis. Osteolysis is bone erosion. The bone is dissolving or lost. There is a localized area of inflammation, hyperemia, microfracture, bone resorption and eventually arthritis of the AC joint. The condition affects the distal end of the clavicle due to micro stress fractures. It typically affects younger male patients. It occurs from activities that require overhead heavy lifting, repetitive motion and the use of a jack hammer. The condition is also common in weight lifters. Examination: localized pain, swelling and tenderness over the AC joint area. Positive cross body adduction test. 90 degree flexed arm is adducted across the chest to the opposite side. X-ray shows erosion of the outer end of the clavicle. The acromion is OK. You may see osteopenia, osteolysis, tapering and cystic changes of the clavicle. An MRI may be obtained to rule out additional shoulder pathology. MRI will show high signal in distal clavicle. Acromioclavicular joint radiography- Zanca view: direction of the x-ray beam is directed with cephalad angle of 10 degrees. Clavicular osteolysis can be assessed using the Zanca view. The acromion will be normal with the abnormality isolated to the distal clavicle. Zanca view is also used for diagnosis of arthritis of the AC joint. It will show osteophytes and joint space narrowing. The findings of the x-rays may not represent the patient's real symptoms. Differential diagnosis: erosion or absence of the distal ends of the clavicle may be seen in a wide range of conditions. Bilateral erosions: •Hyperparathyroidism •Rheumatoid arthritis •Scleroderma Unilateral erosion: •Post-traumatic osteolysis •Myeloma •Metastasis •Osteomyelitis Treatment •Rest NSAID •Ice •Activity modification •Injection: blind injection or ultrasound guided injection •Surgery if pain persists despite conservative treatment. Arthroscopic or open resection of the distal clavicle. Arthroscopy allows for evaluation of the shoulder joint. In open surgery, repair the trapezius and deltoid fascia adequately. Surgery is successful in about 90% of cases. Resect 5-10 mm of bone. Keep the posterior-superior ligament intact because it maintains horizontal stability of the clavicle.