Differential Diagnosis for Glenohumeral Joint Changes
- Single most likely diagnosis
- Primary Osteoarthritis (OA): The x-ray findings of narrowed glenohumeral joint spacing, cortical ridging along the margin of the glenoid, and early osteophyte formation along the inferior medial articular surface of the humeral head are characteristic of primary osteoarthritis. The patient's age (63 years old) also supports this diagnosis, as OA is a common condition in older adults.
- Other Likely diagnoses
- Post-traumatic Arthritis: Although the x-ray does not show any evidence of previous fractures or dislocations, post-traumatic arthritis could still be a consideration, especially if the patient has a history of trauma to the shoulder.
- Rheumatoid Arthritis (RA): RA can cause joint space narrowing and osteophyte formation, although it typically affects multiple joints and has other characteristic features such as marginal erosions and uniform joint space narrowing.
- Rotator Cuff Arthropathy: This condition can cause similar x-ray findings to OA, but it is typically associated with a history of rotator cuff tears or chronic shoulder instability.
- Do Not Miss diagnoses
- Septic Arthritis: Although the x-ray does not show any signs of infection, septic arthritis is a medical emergency that requires prompt diagnosis and treatment. A history of fever, joint pain, or recent infection would increase the suspicion for this condition.
- Avascular Necrosis (AVN): AVN of the humeral head can cause similar x-ray findings to OA, but it is typically associated with a history of trauma, steroid use, or other risk factors.
- Rare diagnoses
- Charcot Arthropathy: This condition is characterized by destructive arthritis in the setting of neuropathy, and it can cause similar x-ray findings to OA.
- Hemochromatosis: This genetic disorder can cause OA-like changes in the joints, as well as other systemic symptoms such as skin pigmentation and liver disease.
- Wilson's Disease: This rare genetic disorder can cause OA-like changes in the joints, as well as other systemic symptoms such as liver disease and neurological abnormalities.