Periarthritis of the shoulder. II. Radiological features.

Abstract

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...

Adhesive capsulitis: role of MR imaging in differential diagnosis

“…Arthrography has been the advocated imaging test of choice to assess adhesive capsulitis but has been shown to be unreliable in some cases [5,6]. Arthroscopy has the advantage of directly scrutinising the joint capsule and typically demonstrates pathological change within the subscapularis bursa, rotator interval and axillary pouch [7,8,9,10,11].…”

Evaluation of Arthroscopic Capsular Release Together with Manipulation Under Anesthesia for Treatment of Frozen Shoulder

“…Ça lış ma mız da ek has ta lı ğı olan has ta gru bu ile ol ma yan grup ara sın da, Cons tant skor la rı, WORC in dek si, omuz ha re ket ge niş lik le ri ve izo met rik kas güç le ri ara sın da her han gi bir fark lı lık sap tan ma mış -tır. Ka mi eth 22 ve Wright ve ark., 23 ser vi kal spon dil ar tro pa ti ve do nuk omuz ara sın da sı kı iliş ki sap tamış lar dır. Do nuk omuz, di ya be tik has ta lar da en çok gö rü len prob lem ler den bi ri dir.…”