Background and indications: Acromioclavicular (AC) joint degeneration occurs early in life.¹ The benefit of a local corticosteroid injection is controversial. Symptom relief, however, has been reported up to a year, and on occasion, pain relief can be even longer.² Periarticular corticosteroid injections can lead to local complications, including changes in skin overlying the joint. Ultrasound guidance may improve the procedural accuracy. In a study on 80 cadavers, Borbas et al.³ reported that 90% of injections were intra-articular compared to 70% when palpatory methods were used. In another large cadavEric study, AC joint injections guided by ultrasound had 95% success versus 72% in the palpation group, but there was no significant difference in the accuracy related to experience of the operators.⁴ It is not uncommon for patients presenting with shoulder pain to have several sources of nociception. It is imporTant to recognize the contribution of the AC joint in the overall presentation of patients with shoulder pain. The AC joint may be only one of multiple targeted injections that may be necessary in a patient presenting with shoulder pain. The location of pain arising from the AC joint may be diverse and radiate into the deltoid region and, on occasion, into the radial side of the forearm similar to problems stemming from the rotator cuff and subdeltoid bursa.

Anatomy:

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