What does localized superior shoulder pain during the AC compression test indicate?

What does localized superior shoulder pain during the AC compression test indicate?

• A. Glenohumeral joint involvement.
• B. AC joint involvement.
• C. Subacromial impingement.
• D. Biceps tendinopathy.

Answer: (B)

Focusing the force across the acromioclavicular joint in this test directly stresses that joint. If the patient reports sharp, localized pain right at the top of the shoulder where the clavicle meets the acromion, it points to AC joint pathology (such as arthritis, sprain, or separations). The glenohumeral joint, subacromial space, and biceps tendon are not being stressed in the same targeted way, so they typically produce pain patterns that are not confined to the AC joint during this maneuver. Subacromial impingement often shows pain with overhead movements; biceps tendinopathy tends to cause anterior shoulder pain near the bicipital groove and pain with resisted elbow flexion or forearm supination; glenohumeral problems produce deeper joint pain and motion-related symptoms. Therefore, localized superior shoulder pain during the AC compression test best indicates AC joint involvement.

Focusing the force across the acromioclavicular joint in this test directly stresses that joint. If the patient reports sharp, localized pain right at the top of the shoulder where the clavicle meets the acromion, it points to AC joint pathology (such as arthritis, sprain, or separations). The glenohumeral joint, subacromial space, and biceps tendon are not being stressed in the same targeted way, so they typically produce pain patterns that are not confined to the AC joint during this maneuver. Subacromial impingement often shows pain with overhead movements; biceps tendinopathy tends to cause anterior shoulder pain near the bicipital groove and pain with resisted elbow flexion or forearm supination; glenohumeral problems produce deeper joint pain and motion-related symptoms. Therefore, localized superior shoulder pain during the AC compression test best indicates AC joint involvement.