A Osteoarthritis

Degenerative changes affect the articular cartilage lining the joint interface surfaces. In the shoulder both the glenohumeral joint and the acromioclavicular joints can be affected. Overuse, injury, a genetic predisposition and inappropriate joint movement (poor joint kinematics, for instance abnormal, non concentric motion resulting from a large or decompensated rotator cuff tear, leading to early “cuff arthropathy”)  can lead to osteoarthritis. This is less common that osteoarthritis of weight bearing joints such as the hip or knee.

B)Inflammatory Arthritis

1. Rheumatoid Arthritis _This systemic inflammatory arthritis affects multiple joints including the shoulder.
2. Autoimmune arthritis ( eg SLE, post viral)
3. Crystal Arthropathy (eg gout)

In all forms of arthritis pain increases with activity and is usually felt posteriorly in the case of glenohumeral arthritis and anteriorly in the acromioclavicular arthritis.

Passive and active range of movement are limited and there is muscle atrophy.  Crepitus is common.  Joint margins are tender on palpation.

Treatment Options

1. Physiotherapy and exercise to prevent any further stiffness or muscle wastage.
2. Non-steroidal anti inflammatory drugs
3. Therapeutic injection: Corticsteroid, Hyoluronic Acid preparations
4. Surgery

   Diagnosis is by X-ray and physical examination.  An MRI may be required.