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Condition/Disorder Synonyms

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  • Glenohumeral joint osteoarthritis (OA)

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ICD-9-CM Codes

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  • 715 Osteoarthrosis and allied disorders

  • 715.11 Osteoarthrosis localized primary involving shoulder region

  • 715.21 Osteoarthrosis localized secondary involving shoulder region

  • 715.9 Osteoarthrosis unspecified whether generalized or localized

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ICD-10-CM Codes

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  • M19.019 Primary osteoarthritis, unspecified shoulder

  • M19.219 Secondary osteoarthritis, unspecified shoulder

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Preferred Practice Patterns

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Key Features

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Description

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  • Most common form of arthritis

  • Degenerative joint disease

  • Commonly affects weight-bearing joints

  • Associated with increased age, obesity, previous trauma, previous surgery

  • Associated with abnormal loading of joints

  • Characterized by joint pain

  • Arthrosis

  • Osteoarthrosis

  • Polyarthrosis

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Essentials of Diagnosis

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  • Radiography is standard method for diagnosis

  • Kellgren and Lawrence (KL) grade ≥ 2 (definite radiographic OA)5

  • Osteophytes, joint-space narrowing, sclerosis

  • Cartilage lesions, bone marrow lesions, synovitis, effusion, and subchondral bone attrition/sclerosis

  • Erosion of articular cartilage

  • Synovial hyperplasia

  • Fibrosis

  • Inflammatory cell infiltration

  • Conventional radiograph is most commonly used tool in OA6

  • Diagnosis based on careful history, physical examination, imaging studies, laboratory examination, exclusion of other possible diseases

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General Considerations

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  • Low bone-mineral density (BMD)

  • Repetitive joint use or loading

  • Joint alignment

  • Bone or joint morphology

  • Calcification of the biceps tendon

  • Bone formation, cyst formation

  • Thickening of subchondral bone plate, osteosclerosis

  • Overall joint dysfunction

  • Joint swelling and inflammation (in certain, severe cases)

  • Joint pain

  • Morning stiffness

  • Long-term disease

  • Secondary problems

    • Muscle atrophy and weakness

    • Bony protrusion or prominence

    • Joint deformity

    • Difficulty with ADLs

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Demographics

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  • More common in middle- to older-aged populations

  • Women more commonly affected than men

  • More common African American and Caucasian than other ethnicities

  • May affect approximately 12% of the population in U.S. and other developed countries7

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Clinical Findings

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Signs and Symptoms

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  • Joint pain, aching

  • Joint stiffness

  • Muscle weakness

  • Muscle atrophy

  • Crepitus

  • Bony enlargement

  • Limited range of motion (ROM) in joint

  • Joint-line tenderness

  • Joint deformity in severe cases

  • Activity limitation

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Functional Implications

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  • Limited mobility

  • Household and work-related activity limitations/restrictions

  • Decreased overall activity and participation

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Possible Contributing Causes

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  • Chronic factors affecting the joint (obesity, BMD, LLD)

  • Ageing

  • Chronic and vigorous joint-loading

  • Previous chronic joint injury (e.g., accident, trauma); secondary OA

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Differential Diagnosis

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  • Rheumatoid arthritis

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