How is Glenohumeral Osteoarthritis diagnosed?

Diagnosis typically involves: Medical history and symptom review; Physical examination assessing range of motion, strength, crepitus, and joint tenderness; Plain radiographs (X-rays) that can show joint space narrowing, osteophytes, sclerosis, and deformity; MRI that may evaluate cartilage, rotator cuff, labrum, and other soft tissues when needed.

Glenohumeral Osteoarthritis

Also known as: Glenohumeral joint osteoarthritis, Shoulder osteoarthritis, Shoulder joint osteoarthritis, Glenohumeral OA, Degenerative arthritis of the shoulder, Osteoarthritis of the glenohumeral joint, Shoulder degenerative joint disease (DJD)

Last updated: December 18, 2024

Glenohumeral osteoarthritis is a degenerative condition where cartilage in the shoulder’s ball-and-socket joint may gradually wear down. This can lead to joint space narrowing, bone spurs, and inflammation that often causes pain and stiffness. Symptoms may develop slowly, vary over time, and include pain with activity or at rest and reduced range of motion. Activity modification and pacing may reduce symptom provocation; changes may progress over years at varying rates.

Key Facts

•Glenohumeral osteoarthritis is a degenerative joint condition in which the cartilage of the shoulder’s ball-and-socket joint gradually wears down
•Shoulder pain that worsens with activity and occurs at rest
•Diagnosed through history, physical exam, and imaging
•First-line treatment includes exercise, weight management, and activity modification

What It Is

Glenohumeral osteoarthritis is a degenerative joint condition in which the cartilage of the shoulder’s ball-and-socket joint may gradually wear down. The resulting changes can include joint space narrowing, bone spur formation, and inflammation that often contributes to pain and stiffness. Symptoms may develop slowly and can vary in severity over time.

Affected Anatomy

This condition affects several structures in and around the joint:

•Glenohumeral joint (shoulder ball-and-socket)
•Humeral head (ball)
•Glenoid (socket of the scapula)
•Articular cartilage
•Synovium (joint lining)
•Joint capsule
•Labrum
•Periarticular muscles and tendons (including the rotator cuff)

Common Symptoms

Symptoms can vary in intensity and may change over time. Common experiences include:

•Shoulder pain that may worsen with activity and can occur at rest
•Stiffness and reduced range of motion, typically with reaching or overhead movement
•Grinding, clicking, or cracking sensations (crepitus) that can occur with motion
•Tenderness around the joint that may occur with palpation or movement
•Weakness or reduced function that can occur due to pain and limited motion
•Night discomfort that may occur, sometimes affecting sleep

Causes and Risk Factors

Multiple factors can contribute to the development of this condition:

Causes

•Age-related cartilage degeneration that can occur without a single clear trigger (primary osteoarthritis)
•Prior shoulder injury (post-traumatic changes) that can contribute to cartilage damage
•Repetitive joint stress that may contribute to wear over time
•Prior shoulder surgery that can be associated with later degenerative changes
•Inflammatory joint disease (such as rheumatoid arthritis) that can cause secondary degenerative changes in the shoulder
•Joint instability or prior dislocations that can contribute to abnormal joint mechanics and cartilage wear

Risk Factors

•Older age
•History of shoulder trauma (fracture, dislocation, significant sprain)
•Prior shoulder surgery
•Occupations or activities that may involve repetitive heavy shoulder use
•Family history of osteoarthritis that can be associated with increased risk
•Inflammatory arthritis or other systemic joint conditions
•Obesity, which can be associated with osteoarthritis risk in general

How It's Diagnosed

Diagnosis typically involves a combination of clinical assessment and imaging studies:

•Medical history and symptom review
•Physical examination assessing range of motion, strength, crepitus, and joint tenderness
•Plain radiographs (X-rays) that can show joint space narrowing, osteophytes, sclerosis, and deformity
•MRI that may evaluate cartilage, rotator cuff, labrum, and other soft tissues when needed
•CT imaging that may help characterize bone anatomy and joint wear patterns, particularly for surgical planning
•Laboratory testing that may help evaluate for inflammatory arthritis or infection when clinical features suggest alternative diagnoses

Treatment Options

Treatment approaches range from conservative measures to surgical interventions, often starting with the least invasive options:

Self-Care and Activity Modification

•Activity modification and pacing strategies that may reduce symptom provocation
•Assistive devices or ergonomic adjustments that may reduce joint strain during daily activities

Physical Therapy and Exercise

•Physical therapy or guided exercise that can improve flexibility, strength, and shoulder mechanics
•Heat or cold modalities that may provide short-term symptom relief

Medications

•Oral or topical analgesics and anti-inflammatory medications that may reduce pain and inflammation

Injections and Office-Based Procedures

•Corticosteroid injections that can reduce inflammation and may provide temporary pain relief
•Hyaluronic acid injections that may be used in some settings, with variable evidence for shoulder osteoarthritis

Surgery

•Surgical options (such as shoulder arthroplasty, including total shoulder replacement or hemiarthroplasty) that can improve pain and function in advanced disease
•Arthroscopic procedures that may be considered in selected cases, typically with variable durability in degenerative disease

Prognosis and Recovery

The course of this condition varies between individuals:

•Symptoms may progress gradually over years, though the rate of change can vary among individuals
•Pain and function may fluctuate, with periods of relative stability and intermittent exacerbations
•Conservative measures may reduce symptoms and improve function for some people, though structural joint changes can persist
•Advanced glenohumeral osteoarthritis may lead to persistent stiffness and functional limitations
•Shoulder arthroplasty can improve pain and function for many people with severe disease, although outcomes can vary based on anatomy, rotator cuff status, and overall health

Total Shoulder Arthroplasty (Shoulder Replacement)(Procedure)
Rotator Cuff Tear(Condition)
Hip Osteoarthritis(Condition)
Knee Osteoarthritis(Condition)

Frequently Asked Questions

Common symptoms include: Shoulder pain that may worsen with activity and can occur at rest; Stiffness and reduced range of motion, typically with reaching or overhead movement; Grinding, clicking, or cracking sensations (crepitus) that can occur with motion; Tenderness around the joint that may occur with palpation or movement; Weakness or reduced function that can occur due to pain and limited motion.

Treatment options range from conservative measures to surgical interventions, including: Activity modification and pacing strategies that may reduce symptom provocation; Physical therapy or guided exercise that can improve flexibility, strength, and shoulder mechanics; Oral or topical analgesics and anti-inflammatory medications that may reduce pain and inflammation; Heat or cold modalities that may provide short-term symptom relief; Corticosteroid injections that can reduce inflammation and may provide temporary pain relief.