Glenohumeral arthritis

Osteoarthritis of the shoulder joint is a degenerative process affecting the articular cartilage of the glenohumeral joint and subchondral bone, in association with bony erosions, osteophytosis, pain and decreased function of the joint. It causes significant pain, functional limitation and disability.

• History of trauma or change in activity levels, location of symptoms, severity and longevity of symptoms, limitation to function
• Night pain
• 24 hour pattern. Possible morning stiffness <30 minutes
• Exclude red flags
• Age (more common in older patients)

• Assess neck movements/ neurology to exclude
• Capsular pattern of movement restriction, loss of external rotation and abduction passively
• In glenohumeral arthritis alone, no pain and weakness on muscle testing but may be a mixed clinical presentation.

X-ray

• Cervical spine/ radiculopathy
• Frozen shoulder if a normal x-ray
• Calcific tendinitis
• Consider red flags and Inflammatory pathology
• Avascular necrosis (AVN)

• Pain relief in line with agreed formularies/guidance
• Patient education, activity modification advice
• Advice to maintain range of motion and rotator cuff exercises
• Worsening statement given
• Possible joint steroid injection for pain relief
• NHS AAA MSK website, Versus Arthritis.

• Diagnostically uncertain
• Symptoms persist beyond despite first line conservative management
• Orthopaedic referral if joint replacement to be considered.