Symptomatic Coracoclavicular Joint - A Case Report of an Important but Lesser known Differential Diagnosis of Shoulder Pain.

INTRODUCTION

Actual coracoclavicular (CC) joint is a rare finding and usually incidental. It is mostly asymptomatic, but few cases have been reported in which there was associated shoulder pain and even brachial plexus neuralgia. It is not to be confused with CC ligament which is a well-known anatomical entity.

CASE REPORT

Here, we present a case of symptomatic CC joint treated at our hospital. A 50-year-old man presented to the outdoor patient department of our hospital with a history of acute on chronic pain in the left shoulder. The pain used to be dull/aching, occurring after some activity and usually relieved on rest. On local examination, mild tenderness was present around the coracoid process. The pain was aggravated on flexion and external rotation of the shoulder. X-ray of the shoulder revealed the presence of a CC joint. It was confirmed by non-contrast computed tomography of the shoulder. Ultrasound-guided injection of local anesthetic and steroid was given in the CC joint, providing instant pain relief to the patient. At 1-year follow-up, the patient is asymptomatic and continuing his daily routine activities.

CONCLUSION

Although CC Joint is a rare entity, its role in causing symptoms is unrefutable. Conservative treatment should be tried before surgical excision. More awareness regarding this joint and its pathology is required for identification and diagnosis.