|►Rotator cuff tear|
|►Advice sheet on shoulder replacement|
|►Advice sheet on injection|
|►Advice sheet on decompression|
|►Advice sheet on stabilization|
|►Advice sheet on cuff repair|
Arthritis of the shoulder
Arthritis is the term given for inflammation of a joint; there are many types of arthritis, but broadly speaking they may be divided into 2 groups. There is osteoarthritis, which is often described as 'wear and tear' arthritis; it tends to occur later in life and normally will only affect a few joints in the body. The other group of arthritis is an inflammatory arthritis, of which rheumatoid arthritis is the most common type. This typically affects slightly younger patients and is associated with more widespread joint disease. The glenohumeral joint and the acromioclavicular joint can both be affected by osteoarthritis and rheumatoid arthritis.
Arthritic change may cause the following changes:
Inflammation of the synovium: This typically gives rise to pain which is made worse by movement of the joint.
Erosion of the articular surface: This results in irregularity of the joint surface and may cause a sensation of grating or clunking on movement.
Damage to the rotator cuff: If the rotator cuff is torn the shoulder no longer has a stable fulcrum and patients frequently lose the ability to raise their arm.
Treatment options available are:
Non-operative management: Anti-inflammatory drugs are useful in the early stages of arthritis and work by reducing the inflammation in the synovial lining of the joint. In rheumatoid arthritis there are other drugs that may be useful in controlling this inflammation. In some cases injection of a steroid (cortisone) into the joint may be useful.
Operative treatment: If the joint surface is severely damaged shoulder replacement may be helpful. There are a number of different designs available. To read more about these click here.
Arthritic change may occur in the acromioclavicular joint (ACJ) after injury. The joint may also be affected by both osteoarthritis and rheumatoid arthritis.
The symptoms of arthritis of the ACJ are those of localised pain in the tip of the shoulder; pain is often worse at the extremes of shoulder movement.
Treatment options are:
Medication: Pain can often be controlled with non-steroidal anti-inflammatory drugs such as ibuprofen or diclofenac.
Injection: Injection of steroid (cortisone) into the ACJ may provide good symptomatic relief.
Surgery: In cases that do not respond to the above treatment excision of the distal clavicle is helpful. If there is an associated instability of the ACJ then a soft tissue reconstruction, such as the Weaver Dunn procedure, may have to be performed.
|© J M Britton 2007|