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HomeHistoryStandardized assessment methods Physical examinationRadiographic evaluationDisease characteristicsDegenerative joint diseaseRheumatoid and other types of inflammatory arthritCuff tear arthropathyCapsulorrhaphy arthropathyAvascular necrosisOther types of arthritis

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Clinical Presentation and Evaluation of Glenohumeral Arthritis.

Last updated Thursday, January 27, 2005

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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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