II. Causes

  1. Primary Shoulder Osteoarthritis (Idiopathic)
  2. Secondary Shoulder Osteoarthritis due to Atraumatic Osteonecrosis
    1. Toxins (e.g. Alcohol Abuse, Corticosteroids, specific cytotoxins, radiation)
    2. Obesity
    3. Lysosomal Storage Disease (e.g. Gaucher's Disease)
    4. Sickle Cell Anemia
  3. Secondary Shoulder Osteoarthritis due to Inflammation
    1. Gout, Pseudogout or other crystal Arthropathy
    2. Following Septic Arthritis
    3. Rheumatoid Arthritis
    4. Rotator Cuff Injury
  4. Secondary Shoulder Osteoarthritis due to Surgery or Trauma
    1. Shoulder Dislocation or Shoulder Subluxation
    2. Prior Proximal Humerus Fracture with malunion
    3. Avascular necrosis
    4. Prior surgery with complications related to hardware, capsulorrhaphy, capsule tightening

III. Epidemiology

  1. Less common site for osteoarthritic changes
  2. Age of onset typically >50 years old

IV. Risk Factors

  1. Chronic rotator cuff disease
  2. Recurrent Shoulder Dislocations
  3. Severe ShoulderFractures
  4. Prior Shoulder surgery

V. Symptoms

  1. Gradual onset of pain and stiffness
  2. Stiffness may significantly limit function when advanced
  3. Chronic Shoulder Pain
  4. Crepitus

VI. Signs

  1. Limited Shoulder Range of Motion - active and passive

VII. Differential Diagnosis

VIII. Imaging

  1. See Shoulder XRay
  2. Signs of Osteoarthritis on XRay: Degenerative changes
    1. Axillary view best demonstrates joint space narrowing
    2. Subchondral sclerosis and osteophytes may also be seen

IX. Management

  1. Analgesics
    1. Acetaminophen 1000 mg orally 2 to 4 times daily
    2. NSAIDs
  2. Supplements
    1. Glucosamine 500 mg orally three times daily
  3. Shoulder Intraarticular Corticosteroid Injection
    1. Consider in refractory cases, but studies do not show significant benefit
  4. Physical Therapy
    1. Avoid aggressive therapy (may exacerbate Osteoarthritis)
    2. Goal is to maintain function and pain control

X. Management: Surgical intervention in severe or refractory cases

  1. Joint preservation surgery (in early disease and young patients under age 60)
    1. Arthroscopic glenohumeral debridement and capsular release (most common)
    2. Corrective osteotomies
    3. Interposition arthroplasty
  2. More aggressive surgical interventions for severe Osteoarthritis
    1. Arthrodesis (fusion of humeral head to glenoid) for severe cases under age 50 years
    2. Hemiarthroplasty (Humerus replacement only)
    3. Total Shoulder Arthroplasty

XI. Prevention

  1. Control comorbid conditions (e.g. Diabetes Mellitus)

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Ontology: Osteoarthritis of glenohumeral joint (C0409939)

Concepts Disease or Syndrome (T047)
SnomedCT 201888001, 156488002, 239864004, 201896006, 373623009, 67315001
English OA-Osteoarthritis of shoulder, Osteoarthritis NOS, of shoulder, Osteoarthritis NOS, of shoulder region, Osteoarthritis NOS, shoulder, Osteoarthritis NOS-shoulder, Osteoarthr glenohumeral joint, Osteoarthritis shoulder joint, osteoarthritis of shoulder, osteoarthrosis of shoulder, osteoarthritis of shoulder (diagnosis), osteoarthrosis of shoulder (diagnosis), osteoarthritis shoulder, shoulder osteoarthritis, Osteoarthritis;shoulder, osteoarthritis of shoulder joint, osteoarthritis shoulder joint, Osteoarthritis of shoulder joint (disorder), Osteoarthritis NOS, of shoulder region (disorder), Osteoarthritis NOS, of shoulder (disorder), DJD of shoulder joint, Osteoarthritis of scapulohumeral joint, Degenerative joint disease of shoulder joint, DJD of scapulohumeral joint, Degenerative joint disease of shoulder region, OA - Osteoarthritis of shoulder, Osteoarthritis of shoulder, Osteoarthritis of glenohumeral joint, Osteoarthritis of shoulder joint, Degenerative joint disease of glenohumeral joint, Degenerative joint disease of shoulder region (disorder), Osteoarthritis of glenohumeral joint (disorder), Osteo arthritis shoulders, Osteoarthritis shoulders, Shoulder osteoarthritis, osteoarthritis of the shoulder
Dutch osteoartritis schouders, schouder osteoartritis
French Arthrose des épaules, Ostéoarthrite des épaules
German Osteoarthritis Schulter, Osteoarthritis Schultern
Italian Osteoartrite della spalla, Osteoartrite delle spalle
Portuguese Osteartrite dos ombros, Osteartrite do ombro
Spanish Artrosis de hombros, Artrosis de hombro, Osteoartritis de los hombros, artrosis de la región del hombro (trastorno), artrosis de la articulación del hombro (trastorno), enfermedad articular degenerativa de región de hombro, enfermedad articular degenerativa de región de hombro (trastorno), artrosis de la región del hombro, artrosis, SAI, de hombro, artrosis de la articulación del hombro, artrosis, SAI, de la región del hombro, artrosis, SAI, de la región del hombro (trastorno), artrosis, SAI, de hombro (trastorno), osteoartrosis de articulación glenohumeral (trastorno), osteoartrosis de articulación glenohumeral
Czech Osteoartritida ramen, Osteoartritida ramene
Japanese 変形性肩関節症, ヘンケイセイカタカンセツショウ
Hungarian Váll arthrosis, Vállízületi arthrosis, Vállak arthrosisa