Clinical Presentation and Evaluation of Glenohumeral Arthritis.
Last updated Thursday, January 27, 2005
History
The patient with significant glenohumeral arthritis usually presents
with pain and loss of function which are refractory to rest,
antiinflammatory medications and exercises. The history should include
a description of the onset of the problem, the mechanism of any
injuries, and the nature and progression of functional difficulties.
Systemic or polyarticular manifestations of sepsis, degenerative joint
disease, or rheumatoid arthritis may provide helpful clues. A past
history of steroid medication, fracture, or working at depths may
suggest the diagnosis of avascular necrosis. Past injury or surgery
suggest the possibility of secondary arthritis or capsulorrhaphy
arthropathy.Standardized assessment methods Recently, standardized methods have been developed by which patients
can assess their health status and shoulder function. Bostrom et al
(Bostrom, Harms-Ringdahl, Nordemar, 1991) found that standardized
assessments of shoulder function more reliable and reproducible than
conventional range of motion measurements. Matsen et al reported the
self assessment of 103 patients with primary glenohumeral degenerative
joint disease. (Matsen, Lippitt, Sidles, et al., 1994; Matsen, Ziegler
and DeBartolo, 1995) Over half reported that their SF 36 pain and
physical role function scores were more than one standard deviation
below those of age and sex-matched controls. These patients
consistently reported the inability to perform standard shoulder
functions, such as sleeping comfortably, lifting 8 pounds to shoulder
height, washing the back of the opposite shoulder, throwing overhand,
and tucking in a shirt behind. Smith et al used self assessment of
shoulder function and health status to compare patients with rheumatoid
arthritis and degenerative joint disease of the shoulder. (Matsen,
Smith, DeBartolo, et al., 1996)
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