- Bruce C Anderson, MD
Bruce C Anderson, MD
- Associate Professor of Medicine
- Oregon Health Sciences University
Osteoarthritis of the glenohumeral joint, a wear-and-tear of the articular cartilage of the glenoid labrum and humeral head, is a relatively uncommon cause of shoulder complaints [1,2]. Trauma precedes the condition in most cases, although the injury may have occurred years earlier. Injuries that are associated with the development of osteoarthritis include previous dislocation, humeral head or neck fracture, and large rotator cuff tendon tears (cuff tear arthropathy) and may also include detachments of the superior glenoid labrum from anterior to posterior (SLAP lesions) . Primary glenohumeral osteoarthritis is more common in women and in patients over the age of 60.
Glenohumeral osteoarthritis must be distinguished from rheumatoid arthritis (RA) affecting the glenohumeral joint. Shoulder involvement is common in RA, although typically fairly late in the course of disease. In one study, 55 percent of 74 patients with RA had developed radiographic evidence of erosive glenohumeral joint disease at 15 years . The symptoms of glenohumeral osteoarthritis and RA affecting the glenohumeral joint are identical; single joint involvement in an older patient suggests the former, while multiple joint involvement tends to occur in the latter. (See "Clinical manifestations of rheumatoid arthritis".)
The clinical examination in patients with glenohumeral osteoarthritis is identical to that of patients with frozen shoulder, and presenting symptoms may be similar (see "Frozen shoulder (adhesive capsulitis)"). Radiographs are diagnostic in the former.
The clinical presentation, evaluation, diagnosis, and treatment of glenohumeral osteoarthritis are reviewed here. The clinical evaluation and use of imaging in patients with shoulder complaints are discussed separately. (See "Evaluation of the patient with shoulder complaints" and "Physical examination of the shoulder" and "Radiologic evaluation of the painful shoulder in adults".)
Patients with glenohumeral osteoarthritis complain of the gradual development of anterior shoulder pain and stiffness over a period of months to years. The patient may rub the front of the shoulder while describing the symptoms. The pain generally is aggravated by activity and is relieved by rest, although patients may complain of night pain.To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- Physical examination
- - Joint line tenderness
- - Restricted range of motion
- - Crepitation
- Acute period
- Persistent symptoms
- - Intraarticular injections
- Glucocorticoid injections
- Intraarticular sodium hyaluronate injections
- Referral and surgery
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