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Distal Clavicle Osteolysis

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Magnus Wennerlund
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Distal clavicle osteolysis, also known as ”weight-lifters shoulder”, can be a very limiting condition. On imaging you can see a small cortical irregularity on the clavicle side of the AC- joint. It is seen on plain radiograph but usually seen in more detail on ultrasound, where you also should look for doppler activity and joint effusion. In this case a 25 year old elite wrestler. When I saw him 2 months ago he had severe symptoms for 7-8 months. Unable to wrestle at all. Tried all kinds of treatments and rehab.
After a thorough discussion with both the patient and the medical team around the wrestle-club we proceeded with an injection of corticosteroids. The patient is still painfree after 2 months and has gradually returned to practice with the help of his physioteam. He is now about to start returning to matches ?‍♂️
Generally this condition can be either stress-induced do to overuse as in this case but it can also be seen post-traumatic with onset weeks to months after the injury.
In many cases the pain settles over time so my general approach to this condition is to get the patient to rest from upper body training for a long enough period and I try to avoid corticosteroid injections as long as possible.