Medical history (history of illness) represents an important component in the diagnosis of omarthrosis (shoulder osteoarthritis). Family history Are there any diseases of the bones and joints in your family that are common? Social history What is your profession? Do you work physically hard in your profession? (regarding specific overload syndromes). Are you left-handed or … Shoulder Osteoarthritis (Omarthrosis): Medical History
Musculoskeletal system and connective tissue (M00-M99). Bursitis (inflammation of the bursa) in the shoulder region. Chronic adhesive capsulitis (capsulitis). Chronic polyarthritis – chronic inflammatory multisystem disease, usually manifested in the form of synovitis (inflammation of the synovial membrane). Impingement syndrome (English “collision”) – the symptomatology of this syndrome is based on the presence of a … Shoulder Osteoarthritis (Omarthrosis): Or something else? Differential Diagnosis
The following are the most important diseases or complications that can be caused by omarthrosis (shoulder osteoarthritis): Musculoskeletal system and connective tissue (M00-M99). Arthritis (inflammation of the joints) Movement restriction Joint malpositions Contractures – permanent shortening of the muscles with resulting joint constraint. Schonhaltung Cervicobrachial syndrome (synonym: shoulder-arm syndrome) – pain in the neck, shoulder … Shoulder Osteoarthritis (Omarthrosis): Complications
Chondroprotectants inhibit cartilage-degrading substances and thus reduce further loss of protective cartilage. At the same time, they promote the regeneration of cartilage tissue.Furthermore, they are believed to have an anti-inflammatory effect. As a result, there is a reduction in pain, swelling and improved joint mobility. The greatest success is achieved by injecting chondroprotectants directly into … Shoulder Osteoarthritis (Omarthrosis): Cartilage-Protective Agents (Chondroprotectants)
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; furthermore: Inspection (viewing). Skin (normal: intact; abrasions/wounds, redness, hematomas (bruises), scars) and mucous membranes. Gait (fluid, limping). Body or joint posture (upright, bent, gentle posture). Malpositions (deformities, contractures, shortenings). Muscle atrophies due … Shoulder Osteoarthritis (Omarthrosis): Examination
Laboratory parameters of the 1st order – obligatory laboratory tests. Small blood count Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate). Uric acid Laboratory parameters 2nd order – depending on the results of the history, physical examination, etc. – for differential diagnostic clarification. Examination of the joint punctate Rheumatoid factor (RF) ANA … Shoulder Osteoarthritis (Omarthrosis): Test and Diagnosis
Therapy goals Pain relief Improvement of mobility Improving the quality of life Delay the progression of osteoarthritis Therapy recommendations Depending on the severity of the disease and individual problems, the following medications can be used: Analgesics (painkillers) Non-acid analgesics Nonsteroidal anti-inflammatory drugs (NSAIDs; non steroidal anti- inflammatory drugs, NSAIDs). Selective COX-2 inhibitors (coxibe). Opioid analgesics … Shoulder Osteoarthritis (Omarthrosis): Drug Therapy
The following symptoms and complaints may indicate omarthrosis (shoulder osteoarthritis): Leading symptoms At the beginning: diffuse omalgia (shoulder pain). Pain on exertion Limited mobility – initially the external rotation (rotational movement of an extremity around its longitudinal axis) is affected (is noticeable by obstructions, for example, hairdressing). Associated symptoms Start-up pain (in the morning after … Shoulder Osteoarthritis (Omarthrosis): Symptoms, Complaints, Signs
Pathogenesis (development of disease) Age-related wear and tear is not the cause of osteoarthritis; rather, acute damage to the articular cartilage from trauma or infection is usually at the beginning of joint destruction. Insufficient matrix synthesis and/or increased cell death of the chondrocytes (cartilage cells) are discussed as pathogenetic mechanisms. In osteoarthritis, the following pathomechanisms … Shoulder Osteoarthritis (Omarthrosis): Causes
General measures Avoidance of: Overloading of the joints, e.g., by competitive and high-performance sports or long-lasting heavy physical loads, e.g., in the profession (construction workers, especially floor layers). Lack of physical activity, since the cartilage gets its micronutrients from the synovial fluid, it is dependent on the joint being moved Conventional non-surgical therapy methods Therapy … Shoulder Osteoarthritis (Omarthrosis): Therapy
Obligatory medical device diagnostics. Radiographs of the shoulder joint, in two planes. Joint space narrowing Formation of caudal (“downward”) osteophytes (new bone formations) at the humeral head (upper end of the humerus) Cranial (“towards the head”) and caudal osteophytes on the glenoid (glenoid cavity of the shoulder joint) Optional medical device diagnostics – depending on … Shoulder Osteoarthritis (Omarthrosis): Diagnostic Tests
The following surgical measures may be considered in the setting of omarthrosis (shoulder osteoarthritis): Arthroscopy of the shoulder joint (arthroscopy) – procedure: Debridement (removal of infected, damaged, or necrotic (dead) tissue/cartilage). Partial surface replacement for cartilage defects at the humeral head (advantages: biomechanics and important structures are preserved in the best possible way)Indications: focal chondral … Shoulder Osteoarthritis (Omarthrosis): Surgical Therapy