Shoulder Arthritis

The most common causes include:

Osteoarthritis (Degenerative Joint Disease)

Osteoarthritis is the most prevalent type of arthritis affecting the shoulder. It results from gradual wear and tear of the cartilage, typically occurring in older adults. Over time, the protective cartilage deteriorates, leading to painful friction between the bones.

Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune disease in which the body’s immune system attacks the synovial lining of the joint, causing inflammation, pain, and cartilage erosion. Rheumatoid arthritis can affect both shoulders simultaneously.

Post-Traumatic Arthritis

Shoulder injuries such as fractures, dislocations, or rotator cuff tears can accelerate joint degeneration. Damage to the cartilage or abnormal joint mechanics following an injury can lead to early-onset arthritis.

Avascular Necrosis (AVN)

Avascular necrosis can lead to osteoarthritis. AVN can weaken the bone and allow the bones to rub together, eventually causing the joint to collapse. It occurs when the blood supply to the head of the upper arm bone is compromised, leading to bone death. Conditions such as excessive steroid use, heavy alcohol consumption, or certain medical conditions (e.g., sickle cell disease) increase the risk of AVN.

Rotator Cuff Arthropathy

Chronic, untreated rotator cuff tears can lead to a condition known as rotator cuff arthropathy. When the rotator cuff fails to support the shoulder, the head of the upper arm bone migrates upward, causing cartilage wear and joint deterioration.

Shoulder arthritis symptoms tend to develop gradually and worsen over time. Common signs include:

Pain

Pain is the most common symptom of shoulder arthritis, often worsening with activity and improving with rest. As the condition progresses, pain may become constant, even occurring at night and disrupting sleep.

Stiffness and Reduced Range of Motion

Patients may experience difficulty raising their arm, reaching overhead, or performing routine activities such as dressing or combing their hair. The stiffness often worsens over time, limiting daily function.

Grinding or Clicking Sensation

As the cartilage wears away, bone-on-bone contact can produce grinding, clicking, or popping sounds (crepitus) when moving the shoulder.

Weakness

Arthritis can weaken the surrounding muscles due to pain-related disuse, making it difficult to lift objects or perform normal shoulder movements.

Swelling and Tenderness

Inflammation within the joint may cause swelling, warmth, or tenderness around the shoulder.

An accurate diagnosis is essential for determining the best treatment approach. Dr. Stephanie Boden employs a comprehensive evaluation process, including:

1. Medical History

A detailed history helps identify risk factors, previous injuries, or underlying conditions contributing to joint degeneration. Patients may be asked about the onset of symptoms, pain severity, functional limitations, and prior treatments.

2. Physical Examination

A thorough physical examination assesses range of motion, strength, joint stability, and areas of tenderness. Specific shoulder maneuvers may be performed to evaluate joint function and rule out other conditions, such as rotator cuff tears.

3. Imaging Studies

• X-rays: The primary imaging tool for diagnosing arthritis, X-rays can reveal joint space narrowing, bone spurs (osteophytes), and bone erosion.
• MRI: An MRI may be ordered to assess soft tissue structures, including the rotator cuff, synovium, and cartilage.
• CT scan: In complex cases, a CT scan provides a detailed, three-dimensional view of bone structure, particularly useful for evaluating severe arthritis or planning surgical interventions.

4. Joint Aspiration (Arthrocentesis)

In cases where infection or inflammatory arthritis is suspected, a small sample of joint fluid may be withdrawn for analysis. This helps distinguish osteoarthritis from conditions like rheumatoid arthritis or gout.