Shoulder Injuries | Dr James McLean | Orthopaedic Surgeon | ASULC | Adelaide

As we age, the smooth surfaces of the cartilage that line the bones of the shoulder joint begin to wear out and become larger, causing osteoarthritis – mainly caused by overuse. This is most common in people over the age of 50.
Symptoms include:

  • Joint pain
  • Tenderness
  • Stiffness

This is an autoimmune disease causing one or more joints to become inflamed, and may affect both shoulders at the same time. Rheumatoid Arthritis can cause your shoulder bones to erode and become deformed over time.
Symptoms include:

  • Tenderness and warmth in the joints
  • Shoulder stiffness, especially in the morning
  • Fatigue, weight loss or fever

When blood cannot reach the long bone in your upper arm (humerus), the cells in your shoulder bone begin to die and subsequently destroys the joint tissue in the shoulder. This is a progressive disease and gradually worsens over time. Avascular necrosis can happen due to shoulder dislocations, fractures or high doses of steroids or alcohol abuse.

Shoulder injuries such as fractures and shoulder dislocations may eventually lead to post-traumatic arthritis, which causes fluid to build up in the shoulder joint, resulting in pain and swelling.

Generally, a rip in the tendons of the rotator cuff causes this form of arthritis to develop.
Symptoms include:

  • Intense pain
  • Muscle weakness that can make lifting difficult

Dr James McLean will conduct a thorough medical history, asking about your symptoms, including their onset, duration, and severity. He will also enquire about any family history of arthritis or other autoimmune diseases, your lifestyle, occupational history, and any previous injuries to the shoulder.

A physical examination will be conducted to assess the affected joints. This includes:

  • Noting any swelling around the shoulder joint.
  • Assessing areas of tenderness and warmth which can indicate inflammation.
  • Testing the shoulder's range of motion to see if movement is limited or painful.
  • Observing any visible deformities or abnormalities in the joint structure.
  • Evaluating the strength of the muscles around the shoulder joint.

Imaging tests are essential to get a detailed look at the joint structure and assess the extent of the damage. Standard imaging tests include:

  • X-rays: These can reveal bone damage, joint space narrowing, and the presence of osteophytes (bone spurs) typical of osteoarthritis.
  • Magnetic Resonance Imaging (MRI): MRI provides a detailed view of bone and soft tissues, including cartilage, tendons, and ligaments. It is beneficial for detecting early signs of rheumatoid arthritis and soft tissue damage.
  • Ultrasound: This imaging technique can help detect inflammation, fluid accumulation, and soft tissue changes in and around the joints.

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Laboratory tests often identify specific markers that can help diagnose arthritis types and rule out other conditions. These may include blood tests, specialised bone scans (where other imaging tests are inconclusive), or arthroscopy.