Libby A K, Sherry D D, Dudgeon B J
Children's Hospital and Medical Center, Seattle, WA 98105.
Arch Phys Med Rehabil. 1991 May;72(6):382-4.
One hundred consecutive children with juvenile rheumatoid arthritis (JRA) were evaluated for shoulder dysfunction. Shoulder arthritis was virtually absent in all 45 children with pauciarticular onset JRA. Twenty of 40 children (50%) with polyarticular JRA and 12 of 15 (80%) with systemic onset JRA had shoulder involvement characterized by pain or restricted passive range of motion (PROM). Ninety-five percent of those with shoulder arthritis had bilateral involvement. Children with systemic onset were likely to have shoulder disease within 2.5 years of onset and to have more severely limited PROM. Children with polyarticular onset developed shoulder arthritis any time during the course of their disease. With either type of onset, internal rotation was the most commonly and severely limited motion, followed by abduction. Clinicians treating children with JRA should carefully monitor pain and examine both rotational and planar components of shoulder motion.
对100名患有幼年类风湿性关节炎（JRA）的儿童进行了肩部功能障碍评估。在所有45例少关节型起病的JRA儿童中，几乎没有肩部关节炎。40例多关节型JRA儿童中有20例（50%），15例全身型起病JRA儿童中有12例（80%）出现肩部受累，表现为疼痛或被动活动范围（PROM）受限。肩部关节炎患者中95%为双侧受累。全身型起病的儿童在发病2.5年内很可能出现肩部疾病，且PROM受限更严重。多关节型起病的儿童在疾病过程中的任何时候都可能发展为肩部关节炎。无论哪种起病类型，内旋都是最常且最严重受限的动作，其次是外展。治疗JRA儿童的临床医生应仔细监测疼痛情况，并检查肩部运动的旋转和平移成分。
