Diagnosis of shoulder arthrosis
To diagnose shoulder arthrosis (omarthrosis), x-rays are required in 2 planes (a. -p. and axial). For anatomical reasons, the beam path of the X-ray tube must be positioned 30° outwards in order to hit the shoulder joint gap straight.
This is important in order to be able to recognize a joint gap narrowing in the early stages as a relatively early sign of arthrosis. Earlier than on the a. -p.-The beginning of the joint space narrowing can be seen in the axial image (shoulder view from the top with the arm raised to the side).
In advanced cases, the typical radiological changes of arthrosis (joint wear and tear), which cannot be distinguished from other joints (e.g. knee arthrosis, hip arthrosis), can be seen. Increased whitening of the articular surfaces of the head of humerus and shoulder joint (subchondral sclerotherapy) is seen as an indication of bone overload in this area, as the cartilage buffer is no longer sufficiently available. Bone attachments (osteophytes) are later added to the head of humerus and glenoid cavity.
In the final stage, there may be a deformation (deformity) of the head of humerus, which loses its spherical structure. At some point, the joint space can no longer be delimited if the cartilage is completely lost. If there is also severe damage to the rotator cuff, the head of humerus can slide up under the acromion (defect arthropathy), which is clearly visible on the X-ray (eccentric omarthrosis).
Shoulder arthrosis cannot be diagnosed with an ultrasound (sonography) of the shoulder. Sonography is important for imaging soft tissue (muscles, tendons, ligaments). It is particularly important as a reliable diagnostic tool for detecting rotator cuff defects (torn rotator cuff).
Its detection is crucial for the further therapy design. In addition to arthrosis of the shoulder joint, there is usually other damage to shoulder structures, particularly to the rotator cuff. Diagnostics using an MRI of the shoulder joint has proven to be particularly useful in this case. For planning a shoulder prosthesis, the CT of the shoulder joint is of greater importance. You can find out more under our topic: MRI examination of the shoulder joint
