What is Periarthritis Humeroscapularis? Causes, Diagnosis and Treatment

by Johnny Jacks

Periarthritis humeroscapularis also known as inflammation around the shoulder joint, is often the result of environmental factors and aging, making it a common condition in individuals over 50 years of age. It frequently occurs in those who engage in heavy labor and have experienced repeated trauma that damages the tendons and muscles surrounding the shoulder joint.

What is Periarthritis Humeroscapularis?

Periarthritis humeroscapularis is a group of soft tissue pathologies that affect the tissues surrounding the shoulder joint, such as tendons, synovial sacs, and joint capsules. These inflammatory conditions are not caused by injuries to the bone, cartilage, or synovial membranes, as seen in infectious arthritis or rheumatoid arthritis. Although not life-threatening, periarthritis humeroscapularis can impact daily activities, work, and quality of life for those affected.

Periarthritis humeroscapularis is classified into four types according to Welfling:

  • Simple shoulder pain caused by tendon pathology.
  • Acute shoulder pain due to synovial fluid effusion.
  • Shoulder joint stiffness caused by inflammation of the synovial membrane, causing the joint capsule to shrink and thicken and reducing the mobility of the shoulder joint.
  • Shoulder joint paralysis caused by rupture of the supraspinatus or subscapularis tendons, leading to immobility of the deltoid muscle.
Periarthritis humeroscapularis dangerous pathology

Periarthritis humeroscapularis dangerous pathology.

Causes of Periarthritis Humeroscapularis

Periarthritis humeroscapularis is often the result of environmental factors or aging, making it more common in individuals over 50 years of age.

The condition can also occur in individuals who frequently engage in heavy labor and experience repetitive injuries, leading to damage to the tendons and muscles around the shoulder joint.

People who participate in high-impact sports that require overhead movements, such as badminton, tennis, and basketball, may also develop periarthritis humeroscapularis due to overuse.

Additionally, the condition can be caused by accidents such as falls, slips, and traffic accidents, which are not adequately treated.

Periarthritis humeroscapularis may also be present in individuals with underlying conditions related to heart, respiratory, breast cancer, nervous system, or those who improperly and unsuitably use sleep aids.

Periarthritis humeroscapularis affecting daily life

Periarthritis humeroscapularis affecting daily life.

How is inflammation around the shoulder joint diagnosed?

Inflammation around the shoulder joint can take many forms, and each form has different symptoms, but in these patients, inflammation factor tests are often negative.

Patients with simple shoulder joint pain usually experience pain in the shoulder joint after excessive shoulder movement or minor continuous trauma. Patients often experience more severe pain when moving the arm against resistance and rarely limit joint movement. These patients often have damage to the supraspinatus or the supraspinatus tendon. Usually, when pressing on the attachment point of the long tendon of the biceps brachii or the supraspinatus tendon, one feels a throbbing pain. X-ray results for these patients are normal, sometimes showing calcium deposits in the tendon, and fluid around the supraspinatus tendon can be seen on ultrasound.

In cases of acute shoulder pain, patients usually experience sudden, intense shoulder pain, even losing sleep due to pain, spreading pain throughout the shoulder, neck, down the arm, and hand. The consequence of this condition can reduce many shoulder joint movements, the ability to extend the arm, shoulder swelling, and heat. In some cases, there may be swelling and redness in the inflamed bursa, and sometimes mild fever. X-rays of these patients have different calcification images in the same shoulder area, which may disappear after a few days. Ultrasound can show fluid in the subacromial bursa when there is acute shoulder pain.

Patients with a frozen shoulder often have severe pain with a cracking sound, and there may be bruises on the upper front of the arm. Moreover, these patients have clear movement limitations, loss of voluntary shoulder elevation, but normal passive movement. Patients do not have neurological symptoms. When examining patients with a ruptured long head of biceps brachii tendon, there is resistance when flexing the arm. In these cases, X-rays or MRI show a ruptured biceps tendon. Ultrasound shows the supraspinatus tendon rupture, blood pooling in the muscle in front of the arm, and the supraspinatus tendon no longer being continuous with retracting at both ends.

Patients with stiff shoulder joints usually experience mechanical shoulder joint pain, which can be painful at night. Patients have limited shoulder joint movement, including active and passive movements, especially in external rotation. MRI may show synovial hypertrophy, inflammation, and capsular thickening.

Treatment protocol for Periarthritis Humeroscapularis

In the treatment of Periarthritis Humeroscapularis, acute attacks of the disease need to be managed along with maintenance treatment. Patients may need to apply various combination therapies including medication, surgical intervention, physical therapy, and functional restoration.

Periarthritis Humeroscapularis needs early treatment

Periarthritis Humeroscapularis needs early treatment

Internal medicine treatment for Periarthritis Humeroscapularis

According to the World Health Organization, patients with Periarthritis Humeroscapularis use pain relievers as follows:

  • Conventional pain relievers used for patients with Periarthritis Humeroscapularis include Acetaminophen or Acetaminophen combined with codeine or Tramadol or Ultracet with pain relief dosages as directed.
  • Patients with Periarthritis Humeroscapularis can be treated with non-steroidal anti-inflammatory drugs such as Diclofenac, Piroxicam Meloxicam, Celecoxib according to drug guidelines.
  • Patients with simple shoulder pain may use intra-articular corticosteroids injected locally. These corticosteroid drugs are injected once into the joint capsule, the subacromial bursa under the deltoid muscle, including Depomedrol 40mg, Diprospan, if recurrence is noted after 3-6 months. Patients with partial tendon rupture due to degeneration should not be injected with corticosteroids as there may be a risk of tendon necrosis and complete rupture.
  • Slow-acting anti-osteoarthritis drugs used for patients with Periarthritis Humeroscapularis include Glucosamine sulfate, Diacerein.
  • For patients with simple shoulder pain or frozen shoulder, physical therapy is applied for treatment when the patient is no longer experiencing pain.

The surgical intervention method for treating Periarthritis Humeroscapularis

Periarthritis Humeroscapularis is treated with surgical intervention when patients with shoulder pain experience pseudo-paralysis, especially in young patients with torn ligaments in the shoulder joint after trauma. At this point, patients need to undergo surgery to connect the torn ligaments and receive restorative treatment. However, caution must be exercised when performing surgical intervention in elderly patients with torn ligaments due to degeneration.

To prevent the risk of Periarthritis Humeroscapularis, a reasonable lifestyle and exercise regime are necessary, especially when experiencing acute pain, the shoulder needs to rest. After successful treatment and pain reduction, physical therapy is used to restore shoulder joint function.

In addition, patients need to ensure proper nutrition and undergo regular check-ups every 1 to 3 months to monitor shoulder joint recovery and progress.

Furthermore, patients should avoid prolonged overwork and activities that involve excessive lifting or raising the arms above the shoulder.

This article has provided basic information on Periarthritis Humeroscapularis, which we hope will be useful to readers.

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