- Rheumatoid Arthritis
- Septic Arthritis
1. Osteoarthritis of Shoulder Joint
Shoulder Joint Osteoarthritis is a most common type of shoulder joint inflammatory disease. Osteoarthritis is often seen in elderly patients. Osteoarthritis causes degeneration of shoulder joint articulating cartilages, rim of the glenoid cavity and ligaments.
Cartilages will slowly get worned out. Eventually lack of cartilages results in joint with bone on bone. Bone spurs are observed over humerus within the joint and adjacent to capsule outside the joint. Bone spurs are bony projections also known as osteophytes. Osteophytes cause irritation of synovial membrane, capsule and ligament resulting in severe pain.
Shoulder Joint Osteoarthritis Is Associated With Irritation Or Inflammation Of Ligaments And Rim Of Glenoid Cavity. Shoulder Joint Osteoarthritis Is Associated With Tendon Inflammation And Causes Rotator Cuff Pain.
Shoulder Joint Is Very Painful To Touch And Movements. Pain Does Respond To Anti-Inflammatory Medications. Pain Is Continuous In Advanced Disease and May Need Advanced Surgical Treatment.
Joint Movements Are Restricted During Initial Phase And Later In Advanced Stage. Patient Is Unable To Carry Weights On Diseased Arm And Do Movements Beyond 20 To 25 Degree Rotation.
2. Rheumatoid Arthritis of Shoulder Joint
Rheumatoid arthritis is an inflammatory disease of shoulder joint. Soft tissue inflammation of capsule and synovial membrane causes thickening of capsule and synovial membrane as well as severe pain. Inflamed synovial membrane secretes excessive amount of synovial fluid resulting in joint effusion and swelling.
Rheumatoid Arthritis causes severe pain and often pain is associated with mild fever. Pain is secondary to damaged cartilage and irritation of ligaments and tendon. Rheumatoid Arthritis also causes Inflammation of ligaments and tendon. Severe case may result in partial tear of ligament and tendon.
In advanced stage of rheumatoid arthritis, shoulder joint often partially dislocate during rapid movement or rotation of shoulder joint.
Subluxation is partial dislocation. Subluxation is either anterior or posterior. Subluxation causes severe sudden pain, which last for several hours. Pain does not respond to NSAIDs and opioids.
Normal shoulder joint movement is painless. Shoulder joint of patient suffering with gout is extremely painful. Pain may last on and often for few days.
Gout is caused by inflammation resulting from uric acid deposits over synovial membrane, cartilage and rim of glenoid cavity.
Uric acid causes inflammation of synovium, articulating cartilage and rim of glenoid socket. Pain is spread over front and back of the shoulder joint. Palpation, pressure and movement of shoulder joint result in severe pain. Tender Painful Swelling is observed over Shoulder Joint. Joint movements such as flexion, extension and rotation are extremely painful during the active period of gout.
Pseudogout is rare and is a painful condition of the shoulder joint. Symptoms are often similar to gout.
Calcium Pyro Phosphate crystals are widely spread in shoulder joint. Crystals are deposited over articulating cartilage, synovial membrane, joint capsule and glenoid cavity. Calcium Pyro Phosphate crystals causes inflammation of cartilage and synovial membrane. Inflammation follows swelling of cartilage and synovial membrane as well as increased secretion of synovial fluid.
Pseudogout is diagnosed following lab study of synovial fluid. Crystals of Calcium Pyrophosphate are lineal long. Crystals are embedded in the surface of cartilage and synovial membrane. Crystals are also observed in Shoulder joint capsule and the edge of the humerus within the shoulder joint.
Pain caused by pseudogout is often spread over front and back of shoulder joint. Pain is severe in the morning and gets less painful later in the day.
Shoulder joint movement is restricted in the morning. Pain becomes less severe as the joint movements are improved during the day. Swelling is observed over front and back of the shoulder joint. Swelling is soft mostly caused by increased secretion of synovial fluid within the joint.
5. Septic Arthritis of Shoulder Joint
Septic Arthritis is caused by infection of shoulder joint resulting in collection of abscess (pus) within the joint. Septic Arthritis can also be caused by penetrating injury or infection from other source spreads to joint through blood. Joint movements are painful. Joint capsule is inflamed. Movement of shoulder joint irritates.Inflame joint capsule causes severe intractable pain.
Skin over the joint is red and hot indicates underlying infection and inflammation. Patient guards and protect the shoulder joint. Patients avoid any movement of shoulder joint. Shoulder joint muscles are contracted or in spasm to prevent shoulder joint movement, which result in severe pain.