[Indications and limitations of conservative and invasive treatment of the inflammatory shoulder joint and the shoulder girdle].

Abstract

An inflammatory rheumatic shoulder can be assessed as a forgotten joint. Apparent problems and deformities of the hands and feet are prioritized in the perception of rheumatic patients. In contrast, however, involvement of the shoulder joint in the context of an inflammatory rheumatic disease is very high with up to 85% [2]. Loss of shoulder function and pain can be well compensated for a long time. This means that further diagnostics are only carried out when the joint is already destroyed and joint-preserving treatment options are obsolete. The various tools of evidence-based conservative treatment can be used to relieve pain and improve function. The cause of joint destruction, inflammatory synovitis, must be treated with medication or, if there is no response to basic immunomodulatory treatment, invasively. In order to contain further destruction of the joint, injections of glucocorticoids and radiosynoviorthesis are initially carried out. This should be followed by arthroscopic synovectomy of the shoulder joint due to better results, especially in early stages of destruction (LDE 0-3).