Wright, V., and Haq, A. M. M. M. (1976). Annals ofthe Rheumatic Diseases, 35,213-219. Periarthritis of the shoulder. Aetiological considerations with particular reference to personality factors. 186 patients with periarthritis of the shoulder have been studied. The sex ratio was female: male, 1-52: 1. The peak age of onset was 54-59 years in both sexes. Over 40% of the patients were referred to the clinic after 6 months had elapsed from the time of onset of the disease. The right shoulder was more frequently involved than the left, particularly in the men. One shoulder only was affected in 75 % of patients. There was frequently a previous history of 'rheumatism' before the episode of periarthritis. In one-third of the women 'nonspecific rheumatism' had occurred. Cervicobrachial pain and a previous episode of shoulder pain had occurred more often in the women.

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Wright, V., and Haq, A. M. M. M. (1976). Annals of the Rheumatic Diseases, 35,220-226. Periarthritis of the shoulder. II. Radiological features. A group of 113 women and 73 men with periarthritis of the shoulder have been studied in detail. Electromyography showed 4 patients with neuralgic amyotrophy who had been referred for the shoulder study but were excluded on this basis. Nerve conduction studies showed little difference between the periarthritic group and a control group, apart from some reduction in amplitude and potential, and in women a suggestion of an increased latency. Duration of the action potential was equal. 6 patients had an undoubtedly long latency compatible with median nerve compression.Degenerative changes were found in the glenohumeral joints in 6-9 %. Degenerative changes were found at the acromioclavicular joints in 31 % of the men and 44 % of the women. Calcification was found around 11 of the shoulder joints. There was frequently a previous history of 'rheumatism' before the episode of periarthritis. In one-third of the women 'nonspecific rheumatism' had occurred. Cervicobrachial pain and a previous episode of shoulder pain had occurred more often in the women.Arthrography was performed in 7 patients and there was a reduction in volume of material that could be injected in only one patient. There was obliteration of the axillary fold in that patient, and a torn capsule in a patient who had previously been manipulated. Lateral cervical spine x-rays were compared with films from an epidemiological survey. The disc space/vertebral body height ratio was taken, overcoming the magnification effects shown by technical alterations in the method of taking films. Good intra-and interobserver correlation was found for this ratio, but not for the width of the canal. There was no difference in the disc/body ratio between the periarthritic and control group in the upper cervical region. In the C5/6 and C6/7 intervertebral discs there was evidence of more disc degeneration in the periarthritic group. The differences from the control group were not great because of the high incidence of disc space narrowing and osteophytosis after the age of 45 years in the general population.In the previous paper a general survey of a group of patients with periarthritis of the shoulder was made, and particular attention paid to psychological factors. Another aspect of the disease which might be quantified was the radiological appearances. For instance, cervical disc degeneration has been cited as an aetiological factor (Oppenheimer, 1938;Kamieth, 1965). The present study has been undertaken to look at this aspect in particular, against the background of clinical and other radiological examinations. Certain electrodiagnostic tests were also undertaken. Materials and methodsThe 186 patients described in the previous paper had an x-ray of the shoulder joint and the films were read for (1) the presence of calcification, (2) degenerative changes in the glenohumeral joint, and (3) changes in the acromioclavicular joint. Ar...

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