Spontaneous Conditions: Degenerative and Other Arthropathy

Osteoarthrosis is less usual, and more forgiving in the shoulder, as it is not load-bearing. Most problems are the late effects of trauma.

Consider aspirating an acute arthropathy to secure the diagnosis.

In the case shown in the image, the shoulder effusion, readily seen on ultrasound, was due to poor warfarin/INR control. Gout may affect the shoulder.

Learning bite

Don’t forget pleural, bilary and diaphragmatic causes of shoulder pain.

Osteonecrosis of the humeral head is in situ and there is death of bone within the humeral head due to disruption of its blood supply. It is also known as avascular necrosis.

The aetiology is secondary to fracture/dislocation, steroid therapy, sickle cell disease, decompression sickness or sepsis.