12. Periarthritis of the shoulder joint

Essay 12- Periarthritis of the shoulder joint

Definition

• Term for a number of different lesions of periarticular structures of shoulder (joint capsule, ligaments, tendons, muscles, insertions, bone)
• Only common feature is pain & limitation of movement in shoulder joint especially during abduction & rotation

Etiology

• Repetitive stretching of rotator cuff
• Repetitive stereotypic movements without breaks
• Chronic static or dynamic overuse of shoulder muscles
• Jumpy movements of abduction & adduction of arm
• Strokes & counterstrokes
• Excessive overhead activity
• Weightlifting, vibration exposure, sudden powerful raising of arm against resistance
• Risk Industries- excavation workers, diggers, miners, press operators, blacksmiths, swimmers, painters, baseball sportsmen

Pathogenesis

• Normally, tendons pass through narrow spaces between bones of shoulder → bursa filled with synovial fluid are located between the tendons as anti-friction devices
• When tendons become thick, bursae recieve a lot of friction and become inflamed (bursitis)
• Tearing of ligament & muscles due to joint imbalance due to weakness in supporting ligaments
• Degenerative changes of periarticular structures develop