Tendonitis of the shoulder joint - diagnosis and prerequisites for occurrence!

The shoulder joint is one of the large, movable articulations of bones in the human body. He is able to perform a variety of movements. Therefore, the pain that appears in it can greatly affect the quality of human life. One of the frequent causes of soreness in the shoulder joint is tendinitis.

What is tendonitis of the shoulder joint?

Tendonitis of the shoulder joint - inflammation of the tendons of this movable articulation of bones. At least once in life, about 2% of people are affected with this disease.

Tendons are tight connective tissue bands designed to connect muscles to the surfaces of bones.

Shoulder joint forms parts of two bones:

• scapular articular cavity;
• the head of the humerus.

The areas of bones in the joint are covered with cartilage. The head is considerably larger than the area of ​​the scapular articular surface. Because of this anatomical peculiarity, the tendons of the five muscles forming the muscle capsule are under great strain. This fact explains why the pain syndrome in the shoulder is often due to tendonitis.

Particularly often, inflammation occurs because of the increased load on the shoulder joint. But there may be other reasons.

Origin of tendinitis of the shoulder

Inflammation in the tendons is determined by various factors, but the primary role is played by large physical loads. Intensive and long-term muscle contraction leads to strong tension, small tears and inflammation in the tendon.

Because of great physical exertion, tendinitis of the shoulder joint is common in athletes, painters, truck farmers, loaders, etc. The age-related loss of elasticity in persons of any gender and hormonal changes in the female body during menopause only increase the risk of tendon inflammation.

Note! It is because of the connection with endocrine changes that tendinitis affects women more often.

But in tendon inflammation there are several more reasons:

• prolonged fixation of the hand due to trauma, for example, with long-term use of gypsum;
• articular pathologies, for example, psoriatic arthritis or gout;
• weakened immunity as a result of taking glucocorticosteroid drugs, chemotherapy, bone marrow transplantation, etc.;
• endocrine disorders( diabetes mellitus and thyroid dysfunction);
• systemic lupus erythematosus and other autoimmune pathologies;
• infections that penetrate the inside of the joint and spread to the tendon tendons, for example, gonorrhea, borreliosis, streptococcus;
• articular injuries, mainly when they are improperly treated;
• osteochondrosis of the neck;
• curvature of the spine and posture disorder;
• stressful effects, leading to muscle spasm, increasing the intensity of the tendon;
• medication allergy;
• congenital locomotor disorders.

Any of these causes leads to the main manifestation of tendinitis - pain.

Symptoms of inflammation in the tendons of the shoulder

Tendonitis of the shoulder joint is manifested by various symptoms:

• pain syndrome;
• limited motion;
• skin redness, fever and swelling at the site of inflammation.

The first two attributes are basic.

Soreness in inflammation of the tendons has several characteristics.

1. It wears a shooting or dull, aching character.
2. Often tortures a person during a night's sleep, which can even lead to insomnia.
3. Localizes mainly in the joint area. Rarely can you see its spread to the elbow.
4. Usually fades and even completely passes at rest.

Locality of pain and their appearance only when moving - one of the signs that already at the stage of physical examination help to conduct differential diagnosis of tendonitis and arthritis.

Pain syndrome is the cause of the appearance of the second mandatory symptom - motor limitation. It is difficult for a man to perform simple movements: combing his hair, holding his hand back or lifting it, etc. At the very beginning of the inflammatory process, only active movements, that is, carried out by the patient himself, are limited because of pain.

Please note! Restriction of movement in the absence of therapy often pass into a chronic form. In advanced cases of the disease, the patient can raise his hand only by 90 degrees.

The nature of the change in motor activity depends on the type of tendinitis.

Kinds of tendon inflammation of the shoulder

Tendonitis of the shoulder joint is a collective name. In the practice of an orthopedist and traumatologist, inflammation of tendons in the region of the shoulder and shoulder joint, indicated in the table, is more common.

Types of tendinitis of the shoulder	Characteristic of
Calcifying	is characterized by calcium deposits; in the degenerative form of the calcium salt is deposited at the sites of damage to the tendon; mechanism of reparative type appearance is not fully understood; the maximum pain syndrome is observed in the period of resorption of calcium deposits; aggravated pain when arm raised; is more often affected by the tendons of the supraclavicular muscle; practically does not lend itself to complete cure; often recurs.
Inflammation of the biceps tendon	is formed against a background of heavy load, for example, in tennis players; pain is localized in the upper and anterior region of the shoulder; leads to difficulty lifting heavy items.
Tendonitis of the supraspinatus	develops when a traumatic effect on the tendon is acromion( the edge of the scapula facing the collarbone), the joint formed by the acromion and clavicle, or the ligament of this joint; leads to difficulty moving the arm from the body to the side.
Tendonitis of the subacute and small round muscle	is accompanied by soreness when the shoulder is turned back.
Inflammation of the tendon of the subscapularis muscle	A characteristic soreness is when the shoulder is turned inwards.

Inflammations of the tendons of the supraspinous, subacute, small round and subscapular muscles are united under the common name of tendonitis of the rotator cuff of the shoulder. But the supraspinatus suffers more often.

Tendonitis of the shoulder joint is also different in severity. A total of 3 types are distinguished, which differ in a different clinical picture.

1. Sick and not intensive. It appears only when moving in a jerk. In the image obtained by X-ray examination, no changes are noted.
   

   Intense aching pain

2. Pain feels worse and accompanies any independent motor activity. When fluoroscopy can be marked bone seals and formations on the shoulder bone, inflammation of the periosteum.
   

   Pain when moving

3. Prolonged pain attacks that do not leave a person even at rest. X-ray reveals changes in the joint.
   

   Tendonitis on X-ray

Important! Seeking help is necessary at the first short-term painful sensations, as the development of the disease leads to the formation of complications.

What is the most dangerous tendonitis of the shoulder joint?

In most cases, tendonitis with timely medical care passes. Pain and difficulty of motor activity recede.

If treatment is delayed, the pathology will eventually lead to complications, which are difficult or completely impossible to eliminate.

1. Movement restriction aggravates inflammation, and also leads to a decrease in the size and operability of the delta and biceps.
2. Inflammation of the tendon of the supraspinatus may become the beginning of development of ankylosis of the humeroscapular joint( immobility caused by the fusion of the articular surfaces of the scapula and humerus).
3. Some types of tendenitis, such as the supraspinatus, can lead to thinning and partial or complete tendon rupture.

. Diagnose and select the necessary therapy regimen that will help cure tendonitis and reduce the risk of unpleasant consequences, can the doctor traumatologist, orthopedist, surgeon.

Diagnosis

In most cases, inflammation of the tendons of the shoulder joint is determined already at the reception. To do this, the doctor evaluates the nature of active movements, which usually cause pain, and therefore are limited. If the doctor himself moves the shoulder( passive movements), then the pain does not arise or is not so intense.

Additional diagnoses can be prescribed for the final diagnosis and exclusion of other pathologies:

• with the MRI of the joint determines areas of degeneration and rupture of the tendon;
  

  MRI for the detection of

• disease US is used to detect ruptures and associated bursitis and arthritis;
  

  Ultrasound of the shoulder joint

• by radiography and CR-arthrography( x-ray with introduction to the contrast joint) reveal calcium inclusions and exclude arthrosis, fracture, dislocation and their consequences;
• arthroscopy is a study that consists in conducting anesthesia in the shoulder of a thin tube for joint examination;
• an introduction to the joint of an anesthetic in tendonitis leads to pain relief, which is a diagnostic sign.
  

  Intra-articular shoulder injections for diagnosing tendonitis

Laboratory methods for determining tendonitis do not play a special role.

Blood tests only change in severe degrees and in the presence of concomitant disease:

• in the general blood test, there is a surplus of leukocytes in the bacterial process;
• in infectious inflammation caused by bacteria, the content of C-reactive protein increases in the blood;
• high concentrations of uric acid are noted with gout;
• rheumatoid factor indicates rheumatoid arthritis.

Diagnosis helps to identify the localization of inflammation, as well as the stage of the pathological process that determines the treatment regimen.

Video - Diagnosis of tendonitis

Video - Calcifying tendonitis