Periarthritis of the shoulder joint
Occupational Diseases / / May 16, 2016
disease is a clinical manifestation of aseptic reactive inflammation, arising under the influence of acute or chronic injury to the shoulder joint periarticular tissues.
for periarthritis of the shoulder joint is characterized by the gradual development of the disease, most of his tendency to relapse and the emergence of a relatively early age (30-40 years), and most often ill Presses hand.Professional periarthritis of the shoulder joint most often occurs in people whose work is associated with prolonged or frequent lifting and diverting working hand (plasterers, painters, firemen, carpenters, masons and so on. D.).
nature and intensity of pain in the shoulder joint periarthritis are different.In some cases, shoulder joint pain disturbed only during operation and under certain provisions of the hand;in other cases predominate pain after operation.In most patients, they occur or are worse at night.Sometimes there is irradiation of pain in the shoulder blade, neck, or in the direction of the
In all cases, shoulder joint periarthritis marked limitation of shoulder abduction, but some patients are unable to take the shoulder of more than 10-15 °, while other pain occur only when shoulder abduction to the horizontal level.Even with sharply expressed pain and significant limitation of abduction of the shoulder arms pendulum movement back and forth along the body preserved in its entirety, and this is important not only for the differential diagnosis of periarthritis with arthritis and artrozoartritom shoulder joint, but also for the selection of a suitable job.
In any even slightly pronounced, periarthritis of the shoulder joint is not practicable laying his hands behind his back.
palpation pain greater tuberosity and at the furrow intertubercular painless axillary hollows typical of periarthritis.Movement of the shoulder joint is very often accompanied by a crunching different sonority, duration and persistence.
X-ray examination often reveals sclerotic changes in the site the greater tuberosity of the humerus and the presence of calcification shadows of varying size, shape and density.Most often visible on the radiograph salt deposits are located in the mucous bags (podakromialnoy and subdeltoid) and other periarticular tissues.
There is no parallelism between the severity of the clinical picture and the presence of periarthritis periarticular deposits.Therefore, do not include a specific form periarthritis called calculous bursitis.Much greater diagnostic value has multiple sclerosis or destruction of the greater tuberosity of the humerus.Periartikulyarpyo Salt deposits in the course of treatment (and sometimes without it) may be reduced or even disappear completely without any appreciable changes in the patient's state of health and change in the functional state of the shoulder joint.
In advanced cases of shoulder joint periarthritis there is stiffness in the shoulder joint ( "frozen shoulder").Long-term violation of the shoulder joint function leads to wasting and atrophy of the deltoid muscle and osteoporosis of the humeral head, seems on the radiograph.
Periarthritis shoulder joint is never accompanied by an increase in body temperature, changes in white blood cells and increased ESR.Not noted as abnormalities of calcium and potassium in the blood serum.
should not resort to immobilization (even short-term) of the shoulder joint, so it can lead to the development of a removable hard stiffness.Only in very severe pain in the shoulder joint is allowed to lay his hand on the scarf, and during the day should be recommended to the patient to take at the time of hand with scarves and perform hand small in motion amount (pendulum movement lowered arm flexion and extension of the forearm, the minimum amount and bringing the shoulder).In exacerbations of chronic shoulder joint periarthritis shown ingestion of dipyrone with reopirin.
During treatment the patient should be released from work and immediately after the end of treatment and even with a significant improvement or complete disappearance of pain and restoration of function of the shoulder joint is necessary to provide the patient to facilitate the work.The duration of temporary employment must be long-term (6-8 weeks).
In some cases, long-term treatment (including sanatorium) is unsuccessful, and the shoulder joint function remains significantly limited;sometimes very satisfactory direct result of the treatment is unstable, and soon after his return to continuous operation in the patient a recurrence of the disease.In such cases, the patient's permanent sustainable employment, while the inevitability of deskilling.