Wright V, Haq A M
Ann Rheum Dis. 1976 Jun;35(3):220-6. doi: 10.1136/ard.35.3.220.
A group of 113 women and 73 men with periarthritis of the shoulder have been studied in detail. Electromyography showed 4 patients with neuralgic amyotrophy who had been referred for the shoulder study but were excluded on this basis. Nerve conduction studies showed little difference between the periarthritic group and a control group, apart from some reduction in amplitude and potential, and in women a suggestion of an increased latency. Duration of the action potential was equal. 6 patients had an undoubtedly long latency compatible with median nerve compression. Degenerative changes were found in the glenohumeral joints in 6-9%. Degenerative changes were found at the acromioclavicular joints in 31% of the men and 44% of the women. Calcification was found around 11 of the shoulder joints. There was frequently a previous history of 'rheumatism' before the episode of periarthritis. In one-third of the women 'nonspecific rheumatism' had occurred. Cervicobrachial pain and a previous episode of shoulder pain had occurred more often in the women. Arthrography was performed in 7 patients and there was a reduction in volume of material that could be injected in only one patient. There was obliteration of the axillary fold in that patient, and a torn capsule in a patient who had previously been manipulated. Lateral cervical spine x-rays were compared with films from an epidemiological survey. The disc space/vertebral body height ratio was taken, overcoming the magnification effects shown by technical alterations in the method of taking films. Good intra- and interobserver correlation was found for this ratio, but not for the width of the canal. There was no difference in the disc/body ratio between the periarthritic and control group in the upper cervical region. In the C5/6 and C6/7 intervertebral discs there was evidence of more disc degeneration in the periarthritic group. The differences from the control group were not great because of the high incidence of disc space narrowing and osteophytosis after the age of 45 years in the general population.
对113名患有肩周炎的女性和73名患有肩周炎的男性进行了详细研究。肌电图显示，有4例患有神经性肌萎缩的患者，他们因肩部问题前来就诊，但基于此被排除。神经传导研究表明，除了一些振幅和电位降低外，肩周炎组与对照组之间差异不大，在女性中还有潜伏期增加的迹象。动作电位的持续时间相等。6例患者的潜伏期无疑较长，符合正中神经受压。在6%-9%的盂肱关节中发现了退行性改变。在31%的男性和44%的女性肩锁关节中发现了退行性改变。在约11个肩关节周围发现了钙化。在肩周炎发作之前，常有“风湿病”病史。三分之一的女性曾患“非特异性风湿病”。女性中颈臂疼痛和既往肩部疼痛发作更为常见。对7例患者进行了关节造影，只有1例患者可注射的物质体积减少。该患者腋窝皱襞消失，1例曾接受过手法治疗的患者出现了关节囊撕裂。将颈椎侧位x光片与一项流行病学调查的胶片进行了比较。采用椎间盘间隙/椎体高度比，克服了拍摄方法的技术改变所显示的放大效应。观察者内和观察者间对该比值的相关性良好，但对椎管宽度的相关性不佳。在颈椎上段，肩周炎组和对照组的椎间盘/椎体比值没有差异。在C5/ C6和C6/ C7椎间盘，肩周炎组有更多椎间盘退变的证据。由于一般人群中45岁以后椎间盘间隙变窄和骨赘形成的发生率较高，与对照组的差异不大。
