Glenohumeral Arthritis

Last updated: February 8, 2026Reviewed date: February 8, 2026Reading time: 5 min read
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Article Summary

Arthritis of the glenohumeral joint is a common cause of debilitating shoulder pain, affecting up to one-third of patients older than 60 years. It is progressive in nature and characterized by irreversible destruction of the humeral head and glenoid articular surfaces. Glenohumeral (shoulder) arthritis is a common source of pain and disability that affects up to 20% of the older population. Damage to the cartilage surfaces of...

Key Takeaways

  • This article explains Other Names in simple medical language.
  • This article explains Background in simple medical language.
  • This article explains Pathophysiology in simple medical language.
  • This article explains Differential Diagnosis in simple medical language.
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Definition

of the glenohumeral joint is a common cause of debilitating shoulder , affecting up to one-third of patients older than 60 years. It is progressive in nature and characterized by irreversible destruction of the humeral head and glenoid articular surfaces.

Glenohumeral (shoulder) arthritis is a common source of pain and that affects up to 20% of the older population. Damage to the surfaces of the glenohumeral joint (the shoulder’s “ball-and-socket” structure) is the primary cause of shoulder arthritis. Replacing the whole shoulder with an artificial joint is usually done to treat arthritis of the glenohumeral joint. Replacement of the head of the , or upper arm bone (hemiarthroplasty). This option, too, is used to treat arthritis of the glenohumeral joint.

Other Names

  • Shoulder Arthritis
  • Shoulder
  • Glenohumeral OA
  • Shoulder
  • Shoulder Arthropathy
  • Rotator Cuff Arthropathy

Background

  • This page describes osteoarthritis of the Glenohumeral Joint
  • Defined as degeneration of the articular surfaces of the humeral head and glenoid
  • Also includes a discussion of  affecting the glenohumeral joint
  • Incidence increases with age (need citation)
  • Women > men (need citation)
  • Chondral injuries (early OA) are seen in 4-17% of patients undergoing routine
  • The third most common joint replaced after the hip and knee

Pathophysiology

Primary Osteoarthritis

  • Only 25-30% of the humeral head articulates with the glenoid fossa at any given time[3]
    • This facilitates increased range of motion at a cost of decreased stability
  • Irreversible loss of articular cartilage, hypertrophic subchondral bone
  • The humeral head undergoes flattening, , and subchondral cyst formation, posterior subluxation
  • Glenoid is also worn down with subchondral cyst formation

Secondary Osteoarthritis

  • Rheumatoid Arthritis
    • synovial , degeneration of joint, medialization of the humeral head
    • Occurs in up to 90% of patients with (need citation)
    • Can also occur with , Pseudogout
  • Post-traumatic
    • Commonly seen following proximal humerus fractures and shoulder dislocations
  • Neuropathic
  • Osteonecrosis or Avascular Necrosis
    • Loss of blood supply with the subsequent collapse of subchondral bone and joint degeneration
  • Rotator cuff arthropathy
    • Rotator cuff tears lead to abnormal glenohumeral articulation

Associated Conditions

Pathoanatomy

  • Static Stabilizers
    • Negative intra-articular pressure[4]
    • The bony geometry of the glenoid surface of the  and Humeral Head
    • Glenoid
    • Glenohumeral
    • Glenohumeral Complex
    • Coracohumeral Ligament
  • Dynamic Stabilizers
    • Rotator Cuff
    • Pectoralis Major
    • Latissimus Dorsi
    • Deltoid
  • Rotator Cuff Tear
    • 5-10% of cases of OA and 25-50% of cases of RA (need citation)
  • Older age
  • Shoulder

  • Fractures
    • Proximal Humerus
    • Humeral Shaft Fracture
    • Fracture
    • Scapula Fracture
    • First Rib Fracture (traumatic or atraumatic)
  • Dislocations & Separations
    • Acromioclavicular Joint Separation
    • Glenohumeral Dislocation ()
    • Sternoclavicular
    • Glenohumeral Instability (Chronic)
  • Arthropathies
    • Glenohumeral Arthritis
    • Acromioclavicular Joint Arthritis
  • Muscle & Injuries
    • Pectoralis Major Injuries
    • Pectoralis Minor Injuries
    • Proximal Biceps Tendon Injuries
    • Scapular Dyskinesis
  • Rotator Cuff
    • Rotator Cuff Tear
    • Rotator Cuff
    • Calcific Tendinitis of the Rotator Cuff
    • Subcoracoid Impingement Syndrome
  • Bursopathies
    • Subacromial Bursitis
    • Scapulothoracic Bursitis
  • Ligament Injuries
    • Glenoid Labral Tears
  • Neuropathies
    • Suprascapular Nerve Injury
    • Parsonage-Turner Syndrome
    • Quadrilateral Space Syndrome
    • Winged Scapula
  • Other
    • Adhesive Capsulitis
    • Paget-Schroetter Syndrome
  • Pediatrics
    • Coracoid Avulsion Fracture
    • Humeral Head Epiphysiolysis (Little League Shoulder)

Diagnosis

  • General: Physical Exam Shoulder
  • History
    • Patients endorse pain, decreased function, and/or loss of motion
    • Pain often is vague and nonspecific
    • Most often patients will endorse chronic, progress symptoms
    • There may be a history of remote trauma or surgery
    • Pain often worse at night or with activity
    • Patients may also endorse catching, locking, or popping
  • Physical
    • May be relatively normal in the setting of mild or moderate symptoms
    • Patients may experience loss of range of motion
    • Mechanical signs include grinding, popping
    • Atrophy of rotator cuff muscles may be observed
  • Special Tests
    • Passive Compression Test: Apply axial compression while passively internally and externally rotating

Radiographs

  • Standard Radiographs Shoulder
  • Arthritis findings: Joint space narrowing, osteophytes, subchondral sclerosis, Cyst
  • High riding humeral head suggests cuff arthropathy

CT

  • Study of choice to evaluate osseous anatomy
  • Consider arthrogram

MRI

  • Better for evaluating soft tissue structures
  • May demonstrate subchomdral edema in OA
  • Helpful for surgical planning and decision making, especially integrity of rotator cuff

Diagnostic Injection

  • See: Glenohumeral Joint Injection
  • Diagnostic injection can help clarify etiology of shoulder pain
  • This can be done as a separate procedure OR during arthrogram for CT/MRI
  • This should be performed under fluoroscopy or ultrasound guidance

Classification

Walch Classification of Glenoid Wear

  • Type A[5]
    • Concentric wear, no subluxation of HH, well centered
    • A1: no or minor central erosion
    • A2: deeper central erosion, line connects anterior/posterior glenoid rims and transects humeral head (HH)
  • Type B
    • Biconcave glenoid, asymmetric glenoid wear and head subluxated posteriorly
    • B0: pre-osteoarthritic posterior subluxation of HH
    • B1: posterior joint narrowing (no posterior bone loss), osteophytes, subchondral sclerosis
    • B2: posterior rim erosion, retroverted glenoid
    • B3: monoconcave, posterior wear, at least HH subluxation >70% OR retroversion >15%
  • Type C
    • C1: Glenoid retroversion >25 degrees, regardless of erosion
    • C2: Biconcave, posterior bone loss, posterior translation of HH
  • Type D
    • Glenoid anteversion or anterior HH subluxation (HH subluxation <40%)

Treatment

Nonoperative

  • Generally considered first-line management
  • Treatment options
    • Relative rest
    • Activity modification
    • Physical Therapy
    • Medications including NSAIDs, Acetaminophen
    • Intra-articular Corticosteroid Injection under ultrasound or fluoroscopy guidance
      • See: Glenohumeral Joint Injection
    • Viscosupplementation is an off-label option
    • Regenerative Medicine has mixed and limited evidence
    • Heat
    • Ice
    • Supplements: Glucosamine, Chondroitin
  • Acute arthritis “flare” can consider
    • Brief period of immobilization in Shoulder Sling

Operative

  • Indications
    • Failure of nonoperative management
  • Technique
    • Total shoulder arthroplasty (TSA) if rotator cuff intact
    • Hemiarthroplasty
    • Reverse shoulder arthroplasty (RSA) if large or irreparable rotator cuff tear
    • Arthroscopy
    • Arthrodesis
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A simple rural-patient checklist to help you explain symptoms clearly, ask better questions, and avoid unsafe self-treatment.

Safety note: This is not a prescription or diagnosis. For severe symptoms, pregnancy danger signs, children with serious illness, chest pain, breathing difficulty, stroke-like weakness, or major injury, seek urgent care.

Which doctor may help?

Orthopedic doctor, rheumatologist, or physiotherapist depending on cause.

What to tell the doctor

  • Write which joints hurt, swelling, morning stiffness duration, fever, injury, and walking difficulty.
  • Bring X-ray, uric acid, ESR/CRP, rheumatoid factor, or previous reports if available.

Questions to ask

  • Is this injury, osteoarthritis, rheumatoid arthritis, gout, infection, or another cause?
  • Which exercises, supports, or lifestyle changes are safe?
  • Do I need blood tests or X-ray?

Tests to discuss

  • Joint examination and range of motion
  • X-ray when chronic arthritis or injury is suspected
  • ESR/CRP, uric acid, rheumatoid tests when inflammatory arthritis is suspected

Avoid these mistakes

  • Do not ignore hot swollen joint with fever.
  • Avoid repeated steroid injections/tablets without a clear diagnosis and follow-up.

Medicine safety and first-aid guide

This section is for patient education only. It does not replace a doctor, pharmacist, or emergency care.

Safe first steps

  • Avoid heavy lifting, sudden bending, and prolonged bed rest.
  • Use comfortable posture and gentle movement as tolerated.
  • Discuss physiotherapy, X-ray, or MRI only when clinically needed.

OTC medicine safety

  • For mild back pain, pain-relief medicine may be discussed with a doctor or pharmacist.
  • Avoid repeated painkiller use if you have kidney disease, stomach ulcer, uncontrolled blood pressure, or are taking blood thinners.

Avoid these mistakes

  • Do not start antibiotics without a proper medical decision.
  • Do not use steroid tablets or injections casually for quick relief.
  • Do not delay emergency care because of home remedies.

Get urgent help if

  • Back pain with leg weakness, numbness around private area, loss of urine/stool control, fever, cancer history, or major injury needs urgent care.
Medicine names, dose, and timing must be decided by a qualified clinician or pharmacist after checking age, pregnancy, allergy, other diseases, and current medicines.

For rural patients and family caregivers

Patient health record and symptom diary

Write your symptoms, medicines already taken, test results, and questions before visiting a doctor. This note stays on your device unless you print or copy it.

Doctor to discuss: Doctor / qualified healthcare provider
Tests to discuss with doctor
  • Basic vital signs: temperature, pulse, blood pressure, oxygen level if needed
  • Relevant blood, urine, imaging, or specialist tests only after clinical assessment
Questions to ask
  • What is the most likely cause of my symptoms?
  • Which warning signs mean I should go to emergency care?
  • Which tests are really needed now?
  • Which medicines are safe for my age, pregnancy status, allergy, kidney/liver/stomach condition, and current medicines?

Emergency warning signs such as chest pain, severe breathing difficulty, sudden weakness, confusion, severe dehydration, major injury, or loss of bladder/bowel control need urgent medical care. Do not wait for online information.

Safe pathway to proper treatment

Care roadmap for: Glenohumeral Arthritis

Use this simple roadmap to understand the next safe steps. It is educational and does not replace examination by a doctor.

Go to emergency care if you notice:
  • Severe or rapidly worsening symptoms
  • Breathing difficulty, chest pain, fainting, confusion, severe weakness, major injury, or severe dehydration
Doctor / service to discuss: Qualified healthcare provider; specialist depends on symptoms and examination.
  1. Step 1

    Check danger signs first

    If danger signs are present, seek emergency care and do not wait for online information.

  2. Step 2

    Record the symptom story

    Write when symptoms started, severity, medicines already taken, allergies, pregnancy status, and test results.

  3. Step 3

    Visit a qualified clinician

    A doctor, nurse, or qualified healthcare provider can examine you and decide which tests or treatment are needed.

  4. Step 4

    Do only useful tests

    Do tests after clinical assessment. Avoid unnecessary tests, random antibiotics, or repeated medicines without diagnosis.

  5. Step 5

    Follow up and return early if worse

    If symptoms worsen, new warning signs appear, or treatment is not helping, return for review quickly.

Rural patient practical tips
  • Take a written symptom diary and all previous prescriptions/test reports.
  • Do not hide medicines already taken, even herbal or over-the-counter medicines.
  • Ask which warning signs mean urgent referral to hospital.

This roadmap is for education. A real diagnosis and treatment plan requires history, examination, and clinical judgment.