Osteoarthritis of the Glenohumeral Joint

Question 1

What is the progressive non-inflammatory disease characterized by degenerative pathological changes in the articular cartilage and its related components?

Answer 1

Osteoarthritis

Question 2

What is osteoarthritis?

Answer 2

• A progressive inflammatory disease
• Degenerative pathological changes in the articular cartilage and its related components

Question 3

history

The typical osteoarthritis patient is how old?

Answer 3

Over 60 years old

Question 4

history

What are the typical complaints of a patient with osteoarthritis?

Answer 4

• Gradual onset of shoulder pain
• Progressively worsening
• Aggravated by activity

Question 5

physical examination

What is the glenohumeral joint range of motion of someone with osteoarthritis?

Answer 5

Decreased active and passive ROM in all planes with no pattern of loss to motion

Question 6

physical examination

If glenohumeral joint pain is chronic, what muscular changes may be seen in the shoulder?

Answer 6

Possible disuse atrophy

Question 7

physical examination

What observations may be found upon palpation of motion of the glenohumeral joint with osteoarthritis?

Answer 7

Crepitus

Question 8

imaging

What type(s) of imaging are used for glenohumeral osteoarthritis?

Answer 8

Radiographs/X-rays
(MRI or CT scan are not usually required for an initial work-up)

Question 9

What is suspected if the following are found in a radiograph of the glenohumeral joint?

• Decreased joint space
• Subchondral sclerosis
• Osteophyte formation

Answer 9

Osteoarthritis

Question 10

imaging

What are the demonstrations of joint destruction found in radiographs of the glenohumeral joint with osteoarthritis?

Answer 10

• Decreased joint space
• Subchondral sclerosis
• Osteophyte formation

Question 11

imaging

Does the amount of joint destruction of the glenohumeral joint caused by osteoarthritis correlate to the amount of pain a patient experiences?

Answer 11

Often it does not

Question 12

treatment

The following are aspects of what type of treatment?

• Ice/heat
• Mobilization or manipulation
• Passive stretching
• Soft tissue mobilization (friction massage, active release)
• Strengthening exercises

Answer 12

Conservative treatment

Question 13

treatment

What are some examples of conservative treatment for glenohumeral joint osteoarthritis?

Answer 13

• Ice/heat
• Mobilization or manipulation
• Passive stretching
• Soft tissue mobilization (friction massage, active release)
• Strengthening exercises

Question 14

mobilization/manipulation

When treating osteoarthritis of the glenohumeral joint, which techniques are often used initially?

Answer 14

Distraction techniques (over gliding techniques) because they are better tolerated

Question 15

When does a chiropractor refer a patient with osteoarthritis of the glenohumeral joint to an orthopedist?

Answer 15

• Severe pain or difficulty sleeping due to pain
• No subjective or objective improvement after 4-6 weeks of treatment

Question 16

If a patient with glenohumeral joint osteoarthritis is in severe pain or having difficulty sleeping due to pain, what should the chiropractor do?

Answer 16

Refer to an orthopedist

Question 17

If a patient with glenohumeral joint osteoarthritis has no subjective or objective improvement after 4-6 weeks of treatment, what should the chiropractor do?

Answer 17

Refer to an orthopedist

Question 18

What are some medical managements for glenohumeral joint osteoarthritis?

Answer 18

• NSAIDs
• Intra-articular corticosteroids (avoid repeated injections)

Question 19

What are some surgical managements for glenohumeral joint osteoarthritis?

Answer 19

• Smoothing/debridement
• Shoulder replacement