Value of dynamic sonography in the management of shoulder pain in patients with rheumatoid arthritis

PurposeThe purpose of this study is to evaluate the role of dynamic high resolution ultrasonography in the detection of abnormalities of rheumatoid arthritis and to find out the value added to the management plan of the disease.Patients and methods21 shoulders of rheumatoid arthritis patients complaining of shoulder pain were scanned with ultrasound (static and dynamic) and compared to clinical examination.ResultThe most predictive sign of rheumatoid arthritis was sub-acromial impingement which was screened and graded by ultrasound in (100%). Other US signs included sub-acromial bursitis in 14.2%, biceps teno-synovitis in 52.4%, supraspinatous tendinopathy in 57.1%, supraspinatous partial thickness bursal surface tear in 14.2% and joint effusion in 9.5% of our patients. The combination of more than one finding was of higher sensitivity than isolated sign alone.ConclusionDynamic ultrasound examination for the diagnosis of shoulder impingement in Rheumatoid arthritis should be done in addition to the clinical and static ultrasound examination to improve the management plan.