Rheumatoid arthritis of the shoulder affects a variety of sites: the acromioclavicular joint, the gleno-humeral joint and synovial bursae. It can lead to chronic synovitis with subsequent joint erosion and rupture of the rotator cuff. RA usually progresses to afflict both shoulder joints.
Clinically, there may be pain and limitation when combing the hair or washing the back. Passive movements are also painful and marked by crepitus. There is often a marked synovial effusion.
Radiologically, loss of cartilage and periarticular erosions are evident.
Treatment ranges from rest to synovectomy - now possible arthroscopically - and excision of the lateral end of the clavicle.
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