Shoulder Arthritis
by dr kalman piper
What Is It?
The shoulder is a ball and socket joint between the scapula and the humerus bones. Like most joints in the body, the ball (humeral head) and the socket (glenoid) are lined with cartilage, which creates an almost friction free articulation between the bones. In general, arthritis is loss of articular cartilage. By far the most common form of arthritis is osteoarthritis, which is mechanical wearing away of the cartilage, however many other forms of arthritis occur.
Symptoms of arthritis include ache – like pain and stiffness in the shoulder. The worn joint often cracks and crunches as it moves (crepitus). Symptoms may be present for many years and gradually worsen with time. The pain is often worse at the end of the day after the shoulder has been used though out the day.
Symptoms of arthritis include ache – like pain and stiffness in the shoulder. The worn joint often cracks and crunches as it moves (crepitus). Symptoms may be present for many years and gradually worsen with time. The pain is often worse at the end of the day after the shoulder has been used though out the day.
How Is It Diagnosed?
Arthritis of the shoulder is usually evident on plain x-rays of the shoulder. Cartilage is not visible on x-ray, however, normally there is a gap between the ball and socket evident on x-ray that is filled by cartilage. When the cartilage is worn away the gap or “joint space” decreases. In severe cases with complete cartilage loss, the two bones touch. In addition, extra bone grows around the joint. The extra bone is called osteophyte, or commonly bone spurs. While the diagnosis of arthritis may be evident on xray, a CT scan or MRI may be necessary to assess the full extent of the arthritis, the condition of the rotator cuff or to plan surgical intervention.
Other Common Conditions Associated With Arthritis Include:
- Rotator Cuff Tears.
- AC Joint arthritis.
- Neck Arthritis.
How Is It Treated?
There are several treatment options available for the treatment of arthritis. They include:
- Analgesia and anti-inflammatory medication.
- Injections of cortisone and local anaesthetic into the join, usually done under ultrasound or CT guidance.
- Physiotherapy
- Joint replacement surgery.
The best treatment will be determined by a number of factors, including your age, the duration and severity of your symptoms, and the presence of other pathologies. It is often worth trying simpler measures such as analgesia and physiotherapy, prior to considering surgery.