Bansal Nitish, Aggarwal Saurabh, Tiwari Punit, Kaur Harmeet
Department of Orthopaedics, Government Medical College, Patiala, Punjab, India.
Department of Orthopaedics, Maharishi Markandeshwar Medical College and Hospital, Solan, Himachal Pradesh, India.
J Orthop Case Rep. 2022 Oct;12(10):54-56. doi: 10.13107/jocr.2022.v12.i10.3364.
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.
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.
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.
实际存在的喙锁关节是一种罕见的发现，通常为偶然发现。它大多无症状，但有少数病例报告称伴有肩部疼痛甚至臂丛神经痛。不应将其与众所周知的解剖结构喙锁韧带相混淆。
在此，我们展示我院治疗的一例有症状的喙锁关节病例。一名50岁男性因左肩慢性疼痛急性发作前来我院门诊。疼痛过去常为钝痛/隐痛，在一些活动后出现，通常休息后缓解。局部检查时，喙突周围有轻度压痛。肩部屈曲和外旋时疼痛加重。肩部X线显示存在喙锁关节。肩部非增强计算机断层扫描证实了这一点。在喙锁关节进行了超声引导下局部麻醉药和类固醇注射，患者疼痛立即缓解。在1年的随访中，患者无症状，继续进行日常活动。
尽管喙锁关节是一种罕见的结构，但其引起症状的作用是不可否认的。在手术切除前应尝试保守治疗。需要更多地了解该关节及其病理情况以进行识别和诊断。
