Rotator cuff dysfunction in patients with rheumatoid arthritis

Area of Science:

• Rheumatology
• Orthopedics
• Radiology

Background:

• Periarticular shoulder problems, especially rotator cuff issues, are prevalent in the general population.
• Rheumatoid arthritis (RA) can manifest with synovitis in shoulder joints, but periarticular problems are also common.

Purpose of the Study:

• To determine the prevalence of shoulder symptoms and abnormalities in RA patients.
• To correlate physical examination findings with magnetic resonance imaging (MRI) results for shoulder abnormalities in RA.

Main Methods:

• Evaluated shoulder function in older, male RA patients using history, physical examination, roentgenograms, and MRI.
• Assessed 40 RA patients, with a subset of 14 undergoing MRI.

Main Results:

• 82% of patients reported shoulder pain, and 88% had abnormal physical exams, primarily involving the rotator cuff.
• Plain roentgenograms showed abnormalities in 38% of patients, while MRI revealed abnormalities in 93% (13 of 14 patients).
• MRI detected a spectrum of rotator cuff abnormalities, from inflammation to complete tears, correlating with physical exam findings.

Conclusions:

• Shoulder problems are common in RA patients, with rotator cuff dysfunction being a frequent cause.
• A comprehensive physical examination is valuable for identifying the cause of shoulder problems in RA.
• MRI is highly sensitive in detecting rotator cuff abnormalities in RA patients.