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  • Glenohumeral joint osteoarthritis (OA)

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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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  • M19.019 Primary osteoarthritis, unspecified shoulder
  • M19.219 Secondary osteoarthritis, unspecified shoulder

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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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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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Laboratory Tests

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  • Synovial fluid examination (optional, not required)
  • Other laboratory tests can be done to rule out other ...

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