Shoulder

Glenohumeral Osteoarthritis

Glenohumeral Osteoarthritis

Introduction

  • Degenerative joint disease affecting cartilage, bone, and soft tissues around the glenohumeral joint.

Epidemiology

  • Common in individuals over 60, but can occur earlier. Symptoms include joint pain, stiffness, and movement restrictions.
  • Risk factors: Age, genetics, joint dysplasia, obesity, excessive exercise, joint trauma, rotator cuff arthropathy, and certain occupations.

Clinical Picture

  • Deep aching, activity-related joint pain, typically posteriorly. Restriction in passive range of motion, particularly external rotation. Night and rest pain, mechanical symptoms like catching, and locking may occur with disease progression.
  • Diagnsosi based on clinical presentation, patient history, physical examination, and confirmed with imaging (X-ray or MRI). BESS criteria include pain >3 months, global ROM reduction, and radiographs to confirm.
  • Differential Diagnoses: Rotator cuff tears, AC joint pain, frozen shoulder, shoulder instability, Parsonage Turner syndrome, avascular necrosis, rheumatoid arthritis, septic arthritis, crystal arthropathies, acromioclavicular OA, neoplasm, and brachial plexitis.

Treatment

  • Medication: Oral paracetamol and NSAIDs recommended for pain management. Opiate-based analgesia not advised for long-term use.
  • Corticosteroid Injections: No evidence supporting routine use.
  • Suprascapular Nerve Block (SSNB): Used for both acute and chronic shoulder pain.
  • Surgery Options: Arthroscopy, Hemi-arthroplasty, Humeral Head Resurfacing, Anatomic Total Shoulder Arthroplasty, Reverse Total Shoulder Arthroplasty,
  • Physical therapy as part of a multimodal treatment strategy showed sustained improvements in a trial by Guo et al. (2016).
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References

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Guo, J. J., Wu, K., Guan, H., Zhang, L., Ji, C., Yang, H., & Tang, T. (2016). Three-Year Follow-up of Conservative Treatments of Shoulder Osteoarthritis in Older Patients. Orthopedics, 39(4), e634–e641.

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