Rheumatology Medical News about Shoulder, Osteoarthritis, Radiological parameters

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How much are radiological parameters related to clinical symptoms and function in osteoarthritis of the shoulder
International Orthopaedics, 08/12/09

Kircher J et al. – Study illustrates that joint space narrowing and development of osteophytes are reliable but independent parameters of primary shoulder arthrosis and should be recorded separately. The size of the caudal humeral osteophyte is a predictive factor for function and should be taken into account for clinical decision making. The primary clinical feature, pain, as the main indication for surgery is not related to radiological parameters.

Methods

Study aims to:
- Examine the radiological features of arthrosis in relation to clinical findings and the radiological appearance in degenerative shoulder joint disease, and
- Decision making about the timing of joint replacement
120 standardised X-rays of pts with advanced OA of the shoulder were examined
Exclusion criteria included rotator cuff tear, severe glenoid erosion or protrusion
Measurements of joint space width at 3 levels in each plane, humeral head diameter and size of humeral osteophytes were made by 2 independent examiners
OA was graded according to Samilson and Prieto

Results

75 of these pts had a complete record from the clinical investigation and the constant score
Mean joint space width in the central anteroposterior level was 1.46 mm±1.08 and in the central axillary 0.98 mm±1.02
Increasing age was positively correlated with joint space narrowing at all measured levels
Joint space width was not correlated with the Samilson grade or the size of osteophytes
Joint space width was neither correlated with pain nor active or passive ROM
Pain was correlated with active and passive flexion and abduction but not for internal or external rotation
Size of the osteophytes was negatively correlated with flexion, abduction and external and internal rotation

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