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Synovitis as a concomitant disease in shoulder pathologies.

Katharina Stahnke1, Lars Morawietz2, Philipp Moroder1

  • 1Department of Shoulder and Elbow Surgery, Center for Musculoskeletal Surgery, Campus Virchow, Charité-Universitaetsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.

Archives of Orthopaedic and Trauma Surgery
|March 2, 2019
PubMed
Summary

This study reveals that chronic shoulder diseases often involve rotator interval synovitis. Intra-articular conditions and larger rotator cuff tears correlate with higher synovitis scores.

Keywords:
Chronic shoulder diseaseRotator cuff tearRotator intervalSynovial inflammationSynovitisSynovitis score

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Area of Science:

  • Orthopedic Surgery
  • Histopathology
  • Shoulder Joint Anatomy

Background:

  • Rotator interval synovitis frequently accompanies shoulder pathologies but is under-researched.
  • Understanding this phenomenon is crucial for diagnosing and treating chronic shoulder conditions.

Purpose of the Study:

  • To investigate the prevalence of visible synovial reactions in the rotator interval during arthroscopic surgery.
  • To correlate macroscopic findings with histopathological synovitis scores in patients with chronic shoulder pathologies.

Main Methods:

  • Prospective cohort study of 167 patients undergoing arthroscopic shoulder surgery.
  • Patients were categorized into subgroups based on shoulder pathology (e.g., rotator cuff tears, instability, cartilage damage).
  • Histopathological evaluation of rotator interval synovitis using the Krenn/Morawietz score.

Main Results:

  • Extra-articular pathologies showed lower synovitis scores compared to intra-articular conditions.
  • Larger rotator cuff tears and cartilage damage were associated with significantly higher synovitis scores.
  • Concomitant long head of the biceps pathologies also significantly increased synovitis scores.

Conclusions:

  • Chronic intra- and extra-articular shoulder diseases frequently present with low-grade, histopathologically confirmed synovitis.
  • Intra-articular pathologies appear to be a significant driver of increased rotator interval synovitis.
  • The degree of rotator cuff tear and presence of other intra-articular issues influence synovitis severity.