RESEARCH - Relation of glenohumeral and AC joint destruction in rheumatoid shoulder

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Ann Rheum Dis 2000;59:158 ( February )

Concise report

Relation of glenohumeral and acromioclavicular joint destruction in

rheumatoid shoulder. A 15 year follow up study

Janne T Lehtinen, Kalevi Kaarela, Eero A Belt, Hannu J Kautiainen, Markku J

Kauppi, Matti U K Lehto

Rheumatism Foundation Hospital, Heinola, Finland

OBJECTIVES To evaluate the relation of glenohumeral (GH) and

acromioclavicular (AC) joint involvement in a cohort of 74 patients with

seropositive and erosive rheumatoid arthritis (RA) followed up

prospectively.

METHODS At the 15 year follow up radiographs of 148 shoulders were

evaluated, and the grade of destruction of GH and AC joints were assessed by

the Larsen method. One GH joint arthroplasty had been performed after 13

years of the disease onset and the preoperative radiograph was evaluated.

RESULTS Erosive involvement (Larsen grade 2) was observed in 96 of 148

(65%) of the shoulders. Both GH and AC joints were affected in 62 of 148

(42%) shoulders. GH joint alone was involved in nine (6%) shoulders and only

AC joint was affected in 25 17%) shoulders. AC joint destruction correlated

with the GH joint destruction, r=0.74 (95% confidence intervals (CI) 0.65 to

0.80 ).

CONCLUSION In RA AC joint is affected more often than the GH joint, but in

half of the patients both joints are involved. This should be remembered

when treating painful rheumatoid shoulder.

http://ard.bmjjournals.com/cgi/content/abstract/59/2/158

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