After I saw rheumy, I went to have my x-rays done immediately. Get it all over and done with. And I really want to know what’s going on in there. What can be seen on plain radiographs at this point.
Rheumy was so convinced that if there was any real damage there, that I wouldn’t be moving the shoulder the way I am. I disagree. You get used to pain when it’s there all the time. It ceases to be a signal to stop what you’re doing. You push through it, and ignore it.
My shoulder feels like there is a knife in my back, 24/7. There’s another one in the front of my shoulder. The joint ‘seizes’ so I stretch it and rotate it to ‘release’ it. It cracks very loudly. And yes, that does hurt. But I keep moving it. I don’t want it to seize permanently! I can feel it grinding all the way through its range of motion. And yes, it hurts.
So, the x-ray findings.
No erosions (although when I had an ultrasound last year, I was told there was some erosion of the AC (Acromioclavicular) joint). Maybe because ultrasound is more sensitive, or just differing opinions.
Osteoarthritis of the AC joint. This is where the cartilage lining the joint has worn away. This is the cause of some of the pain.
Sclerosis at the tuberosity suggesting a degree of rotator cuff tendinitis. Apparently this is indicative of a ‘rotator cuff in distress’. You’re telling me…LOL.
The constant synovitis of the shoulder joint eventually erodes the tendons of the rotator cuff. This causes more pain.
This is what they told me 18 months ago, when I had my last ultrasound and cortisone shot in the shoulder. The relief provided by the cortisone shot into the AC joint confirmed this diagnosis. So it all makes sense. The inflammation is still not under control, so the damage continues. The constant inflammation causes the degenerative changes to the cartilage. Osteoarthritis. Also not uncommon in people with severe rheumatoid arthritis. I know I have osteoarthritic damage in my hips also.
This is why the inflammation of rheumatoid arthritis has to be controlled. If it’s not, this is the kind of damage that occurs. And will continue to occur until the inflammation is tamed. And the damage is irreversible.
So degenerative changes. Googling these changes along with ‘Rheumatoid Arthritis’ reveals it to be a complication of RA. It can be hard to treat.
The treatments start conservatively. Ice, anti-inflammatories (nsaids). Then cortisone injections into the joint.
I have done all of those. The pain is still there, every day. Some days worse than others. The cortisone injections help a lot, but rheumy won’t let me have any more of those. So the synovits and wear and tear will continue until surgery is indicated. As will the pain.
It’s not great news. Mostly because the only real treatment is surgery. But it’s not bad enough for surgery yet. So the pain will continue. As will the damage.
But at least I know what’s going on in there. Continuing to use the joint won’t make it worse. Infact, continuing to use the joint is essential to retain the range of motion. So I’ve been doing every thing right, even though it hurts.