Can you explain my right shoulder X‑ray findings, which show moderate acromioclavicular joint arthritis but no fracture, dislocation, or glenohumeral joint abnormality, in simple terms for my relative?

Understanding Your Right Shoulder X-Ray Results

Your X-ray shows wear-and-tear arthritis in the small joint at the top of your shoulder (where your collarbone meets your shoulder blade), but there are no broken bones, dislocations, or other urgent problems. 1, 2

What the Findings Mean in Plain Language

The Acromioclavicular (AC) Joint Arthritis

• The AC joint is the small joint where your collarbone (clavicle) meets the top of your shoulder blade (acromion) 3, 4
• "Moderate loss of joint space" means the cushioning cartilage between these bones has worn down over time, causing the bones to sit closer together than normal 3, 5
• "Articular surface irregularities and sclerosis" means the bone surfaces have become rough and hardened as your body tries to compensate for the lost cartilage 5, 4
• This is essentially osteoarthritis of that specific joint—a common degenerative condition, especially in middle-aged adults 3, 5

What's Normal on Your X-Ray

• No fractures: None of your shoulder bones are broken 1
• No dislocation: Your shoulder joint is properly aligned 1, 2
• Glenohumeral joint preserved: The main ball-and-socket shoulder joint (where your upper arm bone meets your shoulder blade) looks normal with good spacing 1, 4
• Soft tissues unremarkable: The tissues around the bones appear normal on X-ray 1

What Typically Causes AC Joint Arthritis

• Natural wear-and-tear degeneration of the fibrocartilage disk that cushions this joint, most common in middle-aged individuals 3, 5
• Previous shoulder injuries or repetitive overhead activities can accelerate this process 5, 4
• Importantly, many people have similar X-ray findings without any pain, so imaging alone doesn't determine if treatment is needed 5, 6

What Symptoms This Might Cause (If Any)

• Pain at the top of the shoulder, especially with overhead activities or reaching across your body 3, 5
• Discomfort when lying on that shoulder at night 3
• The pain is typically localized to the AC joint area rather than deep in the shoulder 5, 6

What Happens Next

If you're having pain, initial treatment focuses on oral anti-inflammatory medications (like ibuprofen 400-800 mg three to four times daily), activity modification to avoid repetitive overhead movements, and patient education on positioning 7, 3

Physical therapy has limited benefit for AC joint arthritis specifically, as therapeutic exercise plays only a minor role compared to other shoulder conditions 3

If conservative measures fail after 6 months, a corticosteroid injection into the AC joint may provide short-term relief, though it doesn't change the underlying arthritis 3, 6

Surgery (distal clavicle resection) is reserved for persistent symptoms after at least 6 months of unsuccessful conservative treatment 3, 8

Important Context

• Asymptomatic AC joint degeneration is extremely common and doesn't always correlate with symptoms—many people have these X-ray findings without any pain 5, 6
• The diagnosis of symptomatic AC joint arthritis requires not just X-ray findings, but also physical examination findings and sometimes a diagnostic injection to confirm the joint is actually the source of pain 3, 6
• The good news: No acute or urgent findings requiring immediate intervention 1, 2