Clinical Presentation and Evaluation of Glenohumeral Arthritis.
Last updated Thursday, January 27, 2005
Disease characteristics
A number of different processes can destroy the glenohumeral joint surface.Establishing criteria Clinical evaluation, management and effectiveness measurement is
facilitated by establishing necessary and sufficient criteria which
enable us to standardize the assignment of each diagnosis. Six of the
more common types of glenohumeral joint destruction include: primary
degenerative joint disease, secondary degenerative joint disease,
rheumatoid arthritis, cuff tear arthropathy, capsulorrhaphy
arthropathy, and avascular necrosis.
In an extension of a recent study on self-assessment of patients
with glenohumeral osteoarthritis (Matsen, Ziegler and DeBartolo, 1995),
patients presenting with these conditions assessed their shoulder
function using the 12 questions of the Simple Shoulder Test.
(Matsen, Lippitt, Sidles, et al., 1994) These individuals with
glenohumeral arthritis had greatest difficulty with overhand throwing,
sleeping comfortably on the affected side, washing the back of the
opposite shoulder, and placing eight pounds on a shelf. Interestingly,
the degree of functional compromise at the time of presentation for
evaluation was comparable for the different diagnoses. Apparently, it
is this level of functional impairment, irrespective of the diagnosis,
that brings the patient in for evaluation.
These individuals also assessed their health status using the SF 36
(see footnote 1). The self-assessed overall health status of
individuals with glenohumeral arthritis is most compromised in the
domains of physical role function and overall comfort. For patients
with primary and secondary degenerative joint disease and cuff tear
arthropathy the other SF 36 parameters, such as vitality and overall
health, were relatively close to population-based age and sex matched
controls. The health status of patients with rheumatoid arthritis,
capsulorrhaphy arthropathy and avascular necrosis was poorer than
controls of the same age and sex. Footnotes Footnote 1: The SF 36 is a general health status self-assessment
used in many fields of medicine.(Radosevich, Wetzler and Wilson, 1994;
Ware, Snow, Kosinski, et al., 1993) It is very useful in orthopaedics
for documenting the general health deficits of patients before and
after reconstructive surgery. The overall comfort and physical role
function scales are most commonly affected by arthritic conditions of
the shoulder. Other SF 36 scores are useful in documenting the
patients' vitality, mental health, general health and social,
emotional, and physical function.
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