Radiographic study of rheumatoid shoulder.

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Changes in the glenohumeral joint and acromioclavicular joint due to RA were radiographically examined in 266 joints of 140 patients with RA shoulder according to the scale of Crossan et al. The patients consisted of 30 males and 110 females aged 19-78 years (mean, 54.0 years) with a history of RA of 1-45 years (mean, 11.4 years) . According to Crossan's classification, 70 joints were Grade 1, 69 were Grade 2, 35 were Grade 3, 31 were Grade 4, and 61 were Grade 5.<BR>Erosion occurred first in the greater tuberosity region and inferomedial region of the glenohumeral joint. Cysts were often observed at sites liable to erosion. The appearance of osteophyte and osteosclerosing changes is considered to be secondary to erosion and articular destruction. Unlike the glenohumeral joint, the joint space of the acromioclavicular joint showed a marked tendency to enlarge when there were a few changes due to OA. In patients available for long-term follow-up, it could be seen that destruction of the shoulder joint progressed with that of the elbow joint. These findings suggest the necessity of functional as well as radiographic evaluation of the shoulder and elbow joints for functional reconstruction of the upper limb.
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