The shoulder is a ball and socket joint with a large range of movement. The joint sometimes needs replacing. This is usually when severe arthritis affects the joint surfaces and the shoulder becomes painful and difficult to move. The arthritis may result from various reasons: Osteoarthritis, Rheumatoid Arthritis, Instability Arthropathy, Post-traumatic (due to fracture malunion) arthropathy, Cuff arthropathy and other.
To provide you with effective treatment, your physician will need to determine which joint is affected and what type of arthritis you have. The following are the three most common forms of arthritis generally found in the shoulder:
Osteoarthritis, or “wear-and-tear” arthritis, is a degenerative condition that destroys the smooth outer covering (articular cartilage) of bone. It usually affects people over 50 years of age and is more common in the acromioclavicular joint than in the glenohumeral shoulder joint.
Rheumatoid arthritis is a systemic inflammatory condition of the joint lining, or synovium. It can affect people of any age and usually affects multiple joints on both sides of the body.
Post-traumatic arthritis is a form of osteoarthritis that develops after an injury, such as a fracture or dislocation of the shoulder. Arthritis can also develop after a rotator cuff tear, termed cuff-deficient arthropathy.
The most common symptom of arthritis of the shoulder is pain, which is aggravated by activity and progressively worsens. If the glenohumeral shoulder joint is affected, the pain is centered in the back of the shoulder and may intensify with changes in the weather. The pain of arthritis in the acromioclavicular joint is focused on the front of the shoulder. Someone with rheumatoid arthritis may have pain in all these areas if both shoulder joints are affected.
Limited motion is another symptom. It may become more difficult to lift your arm to comb your hair or reach up to a shelf. You may hear a clicking or snapping sound (crepitus) as you move your shoulder. As the disease progresses, any movement of the shoulder causes pain. Night pain is common and sleeping may be difficult.
A physical examination and X-rays are needed to properly diagnose arthritis of the shoulder. During the physical examination, your physician will look for:
Weakness (atrophy) in the muscles
Tenderness to touch
Extent of passive (assisted) and active (self-directed) range of motion
Any signs of injury to the muscles, tendons, ligaments surrounding the joint
Signs of previous injury
Involvement of other joints (an indication of rheumatoid arthritis)
Crepitus (a grating sensation inside the joint) with movement
Pain when pressure is placed on the joint
X-rays of an arthritic shoulder will show a narrowing of the joint space, changes in the bone, and the formation of bone spurs (osteophytes).