All about glenohumeral osteoarthritis

Share on Pinterest

Osteoarthritis (OA) occurs over time as general use wears down the smooth cartilage that covers bone. As the cartilage wears away and becomes rough, the protective area between the bones diminishes, and they begin to rub against each other during movement. This can result in pain and a limited range of motion.

Although the GH joint is not a major target site of OA, it can occur there. GH osteoarthritis affects around 16–20% of adults over 65 years old.

It affects the GH joint in the shoulder, where the ball joint, called the humerus, fits into the socket, called the scapula.

Cartilage loss can occur over months or years, and stiffness and pain can increase over time. The condition is serious and can result in severe pain, loss of mobility, and disability.

If doctors find that the GH joint has degenerated, they will look for an underlying inflammatory condition predisposing a person to OA.

GH osteoarthritis can impact a person’s quality of life in numerous ways, such as causing or worsening mental health conditions, disrupting sleep, and impacting independence by preventing people from performing certain movements.

Symptoms may gradually worsen over time and can include:

• swelling around the joint
• a popping or clicking sound when a person moves the shoulder
• pain in the joint, especially after use
• stiffness in the shoulder, often in the morning or after a person has rested
• limited range of motion
• joint instability
• muscle weakness around the shoulder

Osteoarthritis can develop and worsen over several years. Doctors typically describe its progression in the following stages, known as the Kellgren-Lawrence classification:

• Stage 1 (minor): There may be slight damage to the cartilage and a narrowing of space between the joint and the bone. An X-ray or imaging test may reveal bone growths called osteophytes. People typically do not experience pain during this stage.
• Stage 2 (mild): An X-ray may reveal bone spurs and a slight narrowing between the joint and the bone. The bone may also become denser, and the surrounding tissues may harden. The bones do not rub against each other at this stage. However, some minor damage may be apparent.
• Stage 3 (moderate): At this stage, cartilage damage will be visible, the ends of the bones may show some deformity, bone spurs may be apparent, and the space between the bones and the joint will be noticeably narrowed.
• Stage 4 (severe): An X-ray of the GH joint at this stage would reveal significant bone spurs, noticeable cartilage damage, severe narrowing of the space between the bones and joint, and deformity at the ends of the bones. A person may experience severe pain, constant inflammation, friction in the joint, and recurring stiffness.

The most common cause of GH osteoarthritis is wear and tear as people age, and cartilage wears away over time.

Secondary causes include:

• surgery
• trauma, such as dislocation
• infectious or crystalline arthropathy, a group of joint disorders in which crystal deposits form in the joints and surrounding soft tissues
• avascular necrosis, which is the death of bone tissue due to an interruption in the blood supply
• an underlying inflammatory or autoimmune condition, especially rheumatoid arthritis

General risk factors for osteoarthritis include:

• aging, with people over 50 years old at higher risk
• sex assigned at birth, as females are at higher risk than males
• obesity
• a family history of osteoarthritis
• surgery or past trauma of the joint
• joint overuse
• a joint that does not line up correctly

To diagnose GH osteoarthritis, a doctor may take a personal and family medical history and perform or order various tests. These may include:

• a physical exam
• imaging scans, such as X-rays, scans, and ultrasounds, which can reveal inflammation, bone spurs, and narrowing of the space between the bone and the joint
• blood tests, which can help rule out other potential causes of symptoms, such as inflammatory arthritis
• a synovial fluid analysis, in which the doctor withdraws fluid from the joint for laboratory analysis to help eliminate other diagnoses

Treatment for GH osteoarthritis aims to minimize functional loss and pain. Options may include:

• avoiding overuse of the joint and activities that cause pain
• regular exercise to help improve strength around the shoulder joint
• occupational therapy
• weight loss for patients with obesity to reduce strain on the joint
• using supportive equipment, such as a brace or splint
• topical or oral medication such as nonsteroidal anti-inflammatory drugs and acetaminophen
• joint injections, such as glucocorticoids
• surgery

Complications of GH osteoarthritis can include:

• decreased range of motion of the shoulder
• pain
• malalignment of the shoulder
• injury or damage to the nerve roots in the shoulder

While no cure for osteoarthritis exists, treatment can help people manage and reduce symptoms.

The condition is progressive and worsens over time. Certain risk factors can cause rapid progression, such as obesity and advanced age.

Surgeries such as joint replacement may improve a person’s outlook, although surgeons may need to replace prosthetic joints within 10–15 years. Surgery may also result in complications, which can be severe.

It is best for people to discuss their individual outlooks and treatment options with a medical professional.

Glenohumeral (GH) osteoarthritis occurs as the cartilage in the ball-and-socket shoulder joint wears down over time, and the bones begin to rub against each other.

The condition can cause severe pain and impact the shoulder’s range of motion. It is progressive and typically occurs due to wear and tear over time. Risk factors include aging, obesity, and a family history of osteoarthritis.

There is currently no cure for the condition. However, treatments such as medication and exercise may help people manage their symptoms.