Shoulder periatrosis is a pathology that leads to irreversible changes in the soft tissues surrounding the shoulder joint. The disease has a chronic, slowly progressing course, and in the later stages is manifested by a marked decrease in the functionality of the shoulder joint.
Causes of pathology
The most common dystrophic changes of the shoulder joint occur in men over forty years of age. The joint of the hand performing the main part of the load is more often affected (in right–handed people – the right one). Predisposing factors are:
increased load on the shoulder joint;
inflammation of the tendons surrounding the capsule of the shoulder joint;
inflammation of the mucous membrane of the articular bag;
traumatic injuries of the joint and its surrounding connective tissue structures;
prolonged immobilization of the joint during immobilization of the limb.
Concomitant somatic diseases (ischemic heart disease, myocardial infarction, blood vessel pathology, diabetes mellitus and others) significantly increase the risk of developing periarthrosis.
Symptoms of the disease
In the early stages, the pathology of the shoulder joint does not differ much from the usual inflammatory process, and manifests itself with pain, the intensity of which increases at night. There may be redness of the skin and swelling of the periarticular tissues.
As pathological changes occur in the articular sac and periarticular connective tissue structures, the nature of complaints changes. The patient notes a pronounced stiffness of movements, a significant limitation of their volume. In the later stages, pathological scar tissue grows in the tendons and serous bags and calcium salts are deposited, which can cause complete immobilization of the limb.
Diagnosis of pathology
To make a diagnosis, the doctor conducts a patient survey and an objective examination.
During an objective examination, the asymmetry of the shoulder joints first of all attracts attention. Palpation of the affected joint causes soreness. Depending on which tendon is affected to a greater extent, pain increases when performing certain movements.
Additional diagnostic methods help to confirm the presence of shoulder periatritis or periatrosis, as well as to differentiate it with infectious arthritis, tumor process or traumatic injury of the shoulder. Thus, X-ray examination reveals signs of moderate osteoporosis and calcification of ligaments. After the introduction of an X-ray contrast agent into the joint cavity, pronounced obliterating changes are detected on the resulting arthrogram.
Basic principles of treatment
Therapeutic measures begin with limiting physical activity on the affected joint. However, after the relief of severe pain syndrome, physical therapy is necessary to maintain general mobility and prevent contractures. In the later stages, exercises are performed that help restore the lost volume of movements.
To relieve pain and combat the inflammatory process, nonsteroidal anti-inflammatory drugs of local and systemic type of action are used. If they are ineffective, it is possible to carry out novocaine blockades and prescribe glucocorticosteroids.
Physiotherapy and thermal procedures are actively used.
In the presence of pronounced fibrous contractures, surgical treatment is indicated.
