How is Shoulder arthritis diagnosed?
A diagnosis of shoulder arthritis is made based on the history of a gradual onset of pain in the shoulder. Pain is usually aching in nature and experienced over the front of the shoulder or near the armpit. It is often associated with stiffness in the shoulder and a feeling of roughness when moving the shoulder. Examination shows painful restriction of movements of the shoulder. An X-ray may demonstrate narrowing of the joint, erosion and formation of spurs. An ultrasound scan may be performed to examine the state of the rotator cuff. Special imaging with a CT scan or an MRI scan is sometimes necessary to aid in planning treatment.
How is Shoulder arthritis treated?
In the early phase, pain may be controlled with activity modification and the use of pain relieving or anti-inflammatory medication.
Physiotherapy: You may be advised to see a physiotherapist to treat the stiffness and any associated muscle weakness.
Steroid injection: A steroid injection placed accurately into the joint may provide short-term pain relief. Injections should be avoided if surgery is being contemplated.
Visco-supplement injection: Hyaluronic acid is found in normal joint fluid and helps to lubricate the joint and remove by-products of inflammation. Synthetic hyaluronic acid is available for injection into the joint and may provide substantial relief from pain for a period of 3-6 months in patients with mild to moderate arthritis. These injections are best performed under image guidance.
Arthroscopic Surgery: If symptoms persist despite adequate nonoperative treatment and if the arthritis is not severe, it may be appropriate to undertake arthroscopic treatment. This consists of “key-hole” surgery to remove loose fragments or bone spurs from the joint, release the tight capsule or sleeve of the joint and remove some bone from the undersurface of the acromion. The worn surface of the joint may be treated with microfracture or drilling. Following surgery symptoms will usually improve over a period of time. For further information on surgical treatment, please refer to the section on “Arthroscopic surgery for shoulder arthritis”.
Shoulder replacement surgery: If the arthritis or pain resulting from it is severe, it may be appropriate to consider joint replacement surgery. Shoulder replacements are often very successful at relieving pain and restoring function and quality of life. For further information please refer to the section on “Shoulder replacement surgery”.