THE MANAGMENT OF THE PATIENT WITH PERIARTHRITIS OF THE SHOULDER AT PRIMARY HEALTH CARE

In 16% of all cases of the musculosceletal system pathology the reason for applying to a general practitioner is pain in the shoulder joint, with an annual incidence of 15 new cases per 1,000 patients in primary care centers. Among all shoulder joint diseases, the most frequent (in approximately 80 % of cases) is periarthritis of the shoulder (PS). This pathology usually affects people of working age (40–70 years) and leads to their temporary disability. The incidence of PS in the general population reaches 3–5%. As there are many pathological conditions characterized by severe pain and a limitation of active and passive movements in the shoulder joint, the diagnosis of PS is often misleading, that can lead to choosing the wrong treatment. That is why it is necessary to consider the question of the correct diagnostic program for the PS in the practice of a family doctor. It should be noted that the diagnosis of PS is mainly clinical and is usually based on patients complaints and their examination. Among all medical imaging techniques the most simple and economically affordable method for visualizing the periarticular tissues at the primary health care is ultrasound. The main goals of the therapy of PS are to get rid of pain and return the full volume of movements in the affected limb. A relatively new and promising method in the treatment of joints diseases, including PS, is the use of autologous platelet-rich plasma (APRP). At the present time, our research is being carried out to improve the prognosis of PS at early stages. Patients in the main group, taking NSAIDs and physical rehabilitation (from the sub-acute period), were offered to receive periarticular injections of APRP. Such therapy
gives a positive result in a short term and prolongs the period of remission.