Arthritis is common in joints between the arm bone and the scapula (glenohumeral) and between the collarbone and acromion (acromioclavicular) in the shoulder. When you have pain in the shoulder, it must be known which joint it is from so that it can be treated.
There are three types of arthritis on the shoulder:
Characterized by the corrosion of cartilage covering the joint surfaces. It occurs mostly in people over 50 years old. Acromioclavicular is more common in the joint. Osteoarthritis is not as frequent in other joints in the shoulder joint. There is a triggering factor in the osteoarthritis cases of the shoulder joint. Previous traumas, aseptic necrosis and old age are the most common causes.
The cartilage covering the joint disintegrates, the event proceeds immediately below the bone, there are irregular protrusions at the joint edges, and calcification occurs.
They are usually old people. The main complaint is pain and arm deprivation. On examination, restriction of joint movements is observed.
Joint narrowing, sharp joints, and sclerosis are common. Arthritis and deterioration occur at the junction and surface of the joint.
Conservative treatment is considered in the initial period. Antiinflammatory drugs, shortwave diathermy, massage and exercises may be helpful. Surgical methods (arthrodesis or total joint arthroplasty) are performed in advanced cases
2. Rheumatoid arthritis :
This disease is a systemic disease that affects the joint membranes. It can occur at any age. Usually two shoulders get sick. In shoulder rheumatoid arthritis, the wrist is not as common as the peripheral regions such as the wrist, hands and feet. In RA, the shoulder is often held together with other joints.
Findings; local pain, joint stiffness, temperature increase, swelling due to synovial thickening and partial movement loss.
Drug therapy for RA is performed. In addition, exercise is important in terms of protecting the range of motion of the joint. Total joint arthroplasty is performed in case of loss of motion in the joint at the advanced stage.
It develops after injury such as fracture of the shoulder and dislocation. Rupture of the shoulder swivel cuff (rotator cuff) can also lead to such arthritis.
Tuberculous arthritis Rarely is involvement in the shoulder. Findings; pain, diffuse swelling, local temperature increase, and limitations in joint movements. At the early stage of the radiography, diffuse rarefaction to the glenohumeral region, contraction at the posterior distraction and erosion of the subchondral bone occur.
Antitubic drug therapy is the main rule Arthrodesis is recommended if there is excessive destruction of the joint.
Symptoms And Findings
The most common symptom of shoulder arthritis is pain.
This pain increases with movement and gradually increases. In glenohomeral joint arthritis, pain is felt in the back of the shoulder and can be affected by the weather. In acromioclavicular joint arthritis pain is localized to the anterior part of the shoulder. In rheumatoid arthritis, the pain can be as wide as an entire shoulder. Another symptom is limited movement. It’s hard to take her to the hair or reach a high rafa. During shoulder movements, clicks can be heard (krepitus).
A good physical examination and x-ray are necessary for the diagnosis of shoulder arthritis. During the examination, look at the following:
- Attenuation in the muscles (atrophy)
- Touch sensitivity
- Active and passive movements of the shoulder
- Signs of previous injuries of muscles, tendons and ligaments around the shoulder.
- The presence of disease in other joints (rheumatoid arthritis)
- Krepitus in movements
Arthritic joints in the x-rays are seen as narrowing the joint space. Bones may have prickly extensions. When the local drug is injected into the joint, the pain relief is confirmed.
- As in other arthritis, the first treatment in shoulder arthritis is conservative:
- It is useful to give up acting that activates rest or pain. Be careful when using the arm
- Inflammatory and analgesic drugs are used
- 20-30 minutes of ice application during periods of pain relief reduces inflammation
- If rheumatoid arthritis is present, special medicines are given
- Use of osteoartiride glucosamine and codirin sulfate is beneficial
If conservative methods are unsuccessful at the time of the pain, surgery is the method of choice. As in every surgery, there are complications in shoulder surgery and there are some risks. The orthopedic doctor tries to minimize these risks and complications.
Glenohumeral arthritis may require total shoulder prostheses or partial shoulder prostheses that only the humerus changes. In the case of acromioclavicular arthritis, the clavicle is removed by cutting a piece of bone from the joint that is made with acromion. The resulting space is then filled with healing texture. These methods are generally effective in relieving pain.