ULTRASOUND EVALUATION OF PAINFUL RHEUMATOID SHOULDERS

Objective. To provide more information about various types of rheumato id involvement of the painful shoulder by ultrasonography (US). Method s. US examinations were performed in 44 patients (88 shoulders) with r heumatoid arthritis (RA). The technique of shoulder ultrasonography wa s standardized in studies of 30 healthy volunteers (60 shoulders) with out shoulder complaints. US findings were compared with clinical, labo ratory and radiographic data to find any relationship. Results. Sonogr aphy could reveal inflammatory conditions at early stages of RA when n o radiographic changes were seen. The most common US finding was subac romial-subdeltoid bursitis in 61 shoulders (69%) of 35 patients. Synov itis in the glenohumeral joint was seen in 51 shoulders (58%) of 32 pa tients, biceps tendinitis in 50 shoulders (57%) of 29 patients and cha nges in the supraspinatus tendon in 29 shoulders (33%) of 20 patients. There were multiple rheumatoid symptoms in 61 shoulders (69%), one co ndition resulted in changes:in 17 shoulders (19%) and no visible US fi ndings in 10 shoulders (11%). Clinical findings were rather unspecific . Flexion, abduction and outward rotation were often restricted in sho ulder symptoms, whereas inward rotation was rarely limited. Shoulder s welling indicated subacromial-subdeltoid bursitis. Conclusion. Ultraso nography is a very useful method for rheumatologists and orthopedists to see inside joints. It can provide remarkable help for local injecti on therapy and for planning surgery because of its suitability for eva luation of the extent of rheumatoid disease.