Glenohumeral Joint Arthritis: That You Need To Know
What is Glenohumeral Joint? Is it the same as Shoulder Joint?
The shoulder is not a single joint. Surprisingly, this joint has four joints namely the glenohumeral joint, acromioclavicular joint, sternoclavicular joint, and scapulothoracic joint. Out of these, the glenohumeral joint is the largest synovial joint of the shouler.
What is Glenohumeral Joint Arthritis?
Glenohumeral joint arthritis is the pain and stiffness of the shoulder joint formed between the humeral head and glenoid cavity. It leads to bone erosion, functional limitation, and disability. The most commonly affecting form of arthritis is osteoarthritis—the degeneration of cartilage covering the head of the humerus and glenoid cavity. Other forms of arthritis that affect the glenohumeral joint such as rheumatoid arthritis: are less common.
What are the causes of Glenohumeral Joint Arthritis?
The pain and swelling are due to the friction between bones caused by loss of cartilage and inflammation of the ligaments, tendons, or synovial membrane covering the joint cavity. Joint arthritis is caused by:
- Past traumatic shoulder injury
- Fracture or dislocation of the shoulder
- Massive and prolonged tear in the rotator cuff muscle
- Occupations or hobbies that cause excessive overhead use of arms
- Old age (above 50)
- Sex: Osteoarthritis is more common in women
What are the symptoms of Glenohumeral Joint Arthritis?
You may experience the following symptoms:
- Aching pain deep in the shoulder
- Pain during arm movement — often relieved with rest
- Pain during rest or sleep as the disease progresses
- Decreased range of arm movement due to stiffness
- Less pronounced swelling
- A clicking, catching, or snapping sensation during arm motion
How to make a diagnosis of Glenohumeral Joint Arthritis?
The diagnosis of glenohumeral joint arthritis is made based on:
- Symptoms such as pain and stiffness
- Medical history to know for a previous fracture or dislocation of the shoulder joint
- Physical examination to check for the range of joint motion
- Blood tests to check for rheumatoid factor and other antibodies positive in rheumatoid arthritis
- X-rays can show the loss of space between the head of the humerus and the glenoid cavity
- MRIs can provide detailed images of the soft tissues like ligaments and bones
- CT scan or ultrasound if X-rays are unclear
What is the prognosis of Glenohumeral Joint Arthritis?
There is no cure for glenohumeral joint arthritis. Medications, physical therapy, and other treatment options help slow the progression of the disease and relieve symptoms. Surgery may be needed if the condition does not respond to available nonsurgical treatments.
What are the treatments of Glenohumeral Joint Arthritis?
The doctor may recommend the following:
- Resting and applying ice and heat alternatively over the shoulder
- Over-the-counter pain medications like naproxen. If these don’t relieve pain, he may recommend prescription pain medications.
- Disease-modifying anti-rheumatic drugs (DMARDs) in case of rheumatoid arthritis
- A hyaluronic injection to provide for artificial lubrication
- Strengthening and stretching exercises that help reduce pain and increase range of motion. A physical therapist can help devise an individualized exercise plan.
What are interventional managements?
There are many non-surgical interventional managements before going for surgery. These are:
- Intraarticular steroid injection is the simplest one. It relieve pain and improve the symptoms.
- Platelet rich plasma injection helps in regeration of joint when joint is degenerated.
- Radiofrequency or cryoablation helps in reducing pain when other options has failed and the pationt is not willing for operation.
- Surgery is the last resort. Various surgeries are performed to either replace the total shoulder joint, replace the humeral head, or cut a part of the collar bone.