Clavicular Bone Spurs: Causes, Symptoms, Diagnosis, and Treatment Options
Osteophytes (bone spurs) on the clavicle typically form at the acromioclavicular (AC) or sternoclavicular (SC) joints due to degenerative or mechanical stress.
Etiology
- Osteoarthritis (primary or post-traumatic).
- Repetitive overhead activity (weightlifting, throwing).
- Prior fracture or ligament injury.
- Inflammatory arthritis (RA, psoriatic).
Symptoms
- Localized pain, tenderness over AC/SC joint.
- Pain with cross-body adduction, overhead reach.
- Palpable prominence; crepitus.
- Rare: neurovascular compression (brachial plexus, subclavian vessels) → arm paresthesia, swelling.
Diagnosis
- X-ray (AP, Zanca view for AC joint): joint space narrowing, osteophytes, sclerosis.
- MRI if soft tissue/neurovascular concern.
- Diagnostic injection (lidocaine) confirms pain generator.
Treatment
- Activity modification, NSAIDs, physical therapy (scapular stabilization, rotator cuff strengthening).
- Ultrasound-guided corticosteroid injection (AC joint).
- Surgical: distal clavicle excision (Mumford procedure) for refractory AC joint arthritis; SC joint resection rarely needed.
Most improve with conservative care; surgery reserved for persistent disability.
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