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Arthritis of the shoulder joint: symptoms, treatment

Arthritis of the shoulder joint The inflammatory process in the humeral articulation is a rather rare pathology. In the human body, the small joints of the upper and lower extremities and the spine are most vulnerable and subject to inflammatory changes. The shoulder joint is a fairly large joint, the inflammatory process gets into it only in case of a serious illness. However, the defeat of this particular articulation introduces significant inconvenience and suffering to the patient, chronic arthritis is the cause of the severe disability of a person. With the defeat of the humeral articulation below the lying limb sections can not function properly, so there is a limitation of mobility and other functional capabilities of the elbow joint and hand. In addition, diseases of the shoulder joints may be accompanied by severe pain, which causes a restriction of movements in the thoracic and cervical spine.

Causes and features of the inflammation of the shoulder joint

The causes of arthritis of the shoulder joint are as follows:

  • purulent microbial agents (staphylococcus, Proteus, streptococcus, Pseudomonas aeruginosa), which enter the articular cavity as a result of a generalized septic process;
  • tubercle bacillus, which affects the joint in severe forms of infection;
  • the causative agent of brucellosis;
  • rheumatism.

Brief description of certain types of shoulder arthritis

Purulent arthritis of the shoulder joint

The inflammatory process in the humeral articulation develops due to the ingress of purulent microbial flora into the articular capsule with the blood flow. The first clinical signs of a septic condition are high fever, severe weakness, severe pallor of the skin, impaired functioning of the cardiovascular system. The arthritis of the humeral articulation itself is manifested by redness and swelling of the skin and soft tissues around the joint, soreness in palpation. Joint pain, as a rule, is quite intense, aggravated by movement, and therefore the mobility of the upper limb is sharply limited. When the joint is punctured, purulent contents leak from the cavity. Therapy for purulent arthritis of the shoulder joints includes the use of powerful antibiotics with a wide range of effects, as well as detoxification therapy. During the rehabilitation period, various physiotherapeutic procedures are shown: UHF, magnetic therapy, and electroiontophoresis.

Rheumatic arthritis of the shoulder joint

This disease is allergic and infectious nature. Caused by hemolytic streptococcus, in the future, allergic and autoimmune processes take precedence. Rheumatism is characterized by the symmetry of the affected joints. In the case of rheumatoid arthritis of the shoulder joint, pain and limitation of movement are observed. A person, as a rule, complains not only of pain in his shoulder, but also of morning stiffness in the shoulder joint. The treatment uses a combination of steroid hormones and NSAIDs.

Tuberculous arthritis of the shoulder joint

Tuberculosis infection, covering bone tissue, can occur at any age, but is more typical for pediatric patients. Often, bone tuberculosis develops in an organism that is extremely weakened by other diseases or in the case of a severe untreated or improperly treated infectious process.

The initial signs of a tuberculous process are not so much local changes in the joint, as symptoms of general malaise. A person is worried for a long time:

  • high temperature (often subfebrile, less often - high);
  • unmotivated sweating, especially at night;
  • increasing general weakness;
  • fatigue and general breakdown that does not disappear even after a long rest.

In the joint itself, the tuberculous process goes through several stages, which replace one another and can be quite long. The pre-arthritic stage is dominated by general signs of tuberculosis infection, changes in the shoulder joint are poorly expressed or absent.

The next stage of tuberculous arthritis is actually arthritic, when bone and cartilage tissues of the shoulder joints are involved in the process. There is pain in the shoulder, as a rule, of moderate intensity and aggravated during movement, extending into the shoulder blade or back. There is a limited mobility of the shoulder: a person hardly raises and lowers his arm, cannot hold his arm up for a long time. In the humerus (the tubular part or more often the head of the bone), the formation of sequesters (cavities) and the phenomena of caseous decay are observed (the cheesy masses of the destroyed cells are found inside the cavity).

In the absence of proper treatment, dystrophic and deformational changes begin to dominate in the shoulder joint. The radiological image (lateral and direct projection) shows a narrowing of the joint space, osteoporosis of the bone (a decrease in density due to a decrease in calcium content), the formation of pathological bony outgrowths, the presence of tuberculous cavities, a violation of the structure (trabeculae) of the humerus.

Further, shortening of the upper limb, fusion of the joint space, that is, ankylosis of the joint, is observed. This makes it almost impossible to fully move the shoulder joint and the entire limb as well. Osteoporosis and the presence of tuberculous sequestration leads to increased bone fragility, which in turn leads to an increased risk of fractures.

Treatment of tuberculous arthritis of the shoulder joint is very long and not always successful. Therapy involves the hospitalization of the patient in a specialized medical institution. An important point of successful treatment is the immobility of the shoulder joint until the inflammatory process subsides. For this, a special plaster cast is applied, which fixes not only the shoulder joint itself, but also the entire limb, as well as the upper part of the body. The second important point is the appointment of a long course of combination of 3-4 anti-TB drugs.

In the acute period of the tuberculous process, physiotherapeutic procedures and local remedies are absolutely contraindicated. A person with tuberculosis arthritis is recommended to be high-calorie, enriched with minerals, vitamins and microelements of nutrition, in the absence of other open forms of tuberculosis (for example, infiltrative pulmonary tuberculosis) - staying in fresh air in conditions of specialized sanatoriums in a certain climatic zone.

After subsiding of active tuberculous inflammation, a prosthetic operation of the shoulder joint becomes possible - replacement of the deformed structures with an artificial joint.

Brucellosis arthritis of the shoulder joint

This is a specific inflammation of the shoulder joint, which is most common in the countries of Central Asia, as well as in the Mediterranean basin (one of the names of this infection is Maltese or Mediterranean fever). Professional nature is typical for this infectious disease: people suffering from large and small cattle (livestock breeders, veterinarians, meat processing workers) suffer from this disease. There are frequent cases of brucellosis among people who like to eat milk and dairy products that are not subjected to heat treatment (cottage cheese, cheese).

One of the manifestations of brucellosis is a specific lesion predominantly of the musculoskeletal system, in particular of the shoulder joint. Characterized by changes in several large joints, which develop against the background of other manifestations of the disease.

Among the common signs of brucellosis are fever, increased all groups of lymph nodes, as well as the liver and spleen. In the initial stages of the disease, the joints are little changed: there is a slight soreness, moderate limitation of mobility. In this case, the joint itself is not outwardly changed. During the formation of the chronic form of brucellosis, the damage to the joints gradually begins to predominate in the clinical picture. For example, in the shoulder joint, inflammation develops not only the articular surfaces, but also the articular bursa, as well as the tendons. Gradually, the shoulder joint completely loses its functional abilities, the upper limb cannot perform the necessary movements. Irreversible ankylosis of the joint, muscle contracture and their subsequent atrophy are formed.

The sad feature of Brucella arthritis is the complexity of treatment and its low effectiveness. The appointment of a combination of several antibiotics (a group of tetracycline and aminoglycosides) does not always bring the desired positive effect. The chronic form of brucellosis arthritis of the shoulder joint with signs of deformity cannot be treated. Joint prosthetics for chronic brucellosis is not indicated. A person with this type of shoulder arthritis gets a lifelong disability.

| 17 May 2015 | | 938 | Joint diseases
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Simarjeet Singh: Hi doctor I'm experiencing ac joint pain from past 5-6 months and I've stopped working out expecting that it would help in. Reducing pain , but till now it has gotten no better. My mri scan report says " MILD HYPERTROPHY OF AC JOINT WITH BONE MARROW EDEMA" Till now i haven't got any relief from medications. Plz help what will be the best treatment for this. And can i go back to working out in future?

Elie Sassine: I have done the surgery, I didnt know they have shaved the clavicle. I ve been told that only the acromion is the problem. Now i have pain when I ma reaching across. My question is : Should I have for the rest of my life that pain? Should this disorder remains? Thank you Elie

Kim Happy: I have arthritis in the ACJ and I also have fluid tracking down the long head of biceps tendon sheath, why do I have the fluid there? please can you help me

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Hema Jha: Hello doctor Jo! Myself hema and i am 24 years old and suffering from rheumatoid arthritis for past three months as my RA report was positive at 24.3 and i started homeopathy treatment for it and its still going but stil I have to bear the unbearable pain and right now its in my left shoulder in fore arm i cant lift my arm up at 90° so should i compel my arms at 90° or it would injure me more.......and yes i am from india ...... Thanks in advance doctor Jo!