Diagnosis and relation to general health of shoulder disorders presenting to primary care.
OBJECTIVE
To prospectively evaluate the incidence, spectrum of disease and relation to general health of shoulder disorders in primary care.


METHODS
Patients presenting with shoulder pain to two large general practices in the Cambridge area over a 1-month period were invited to participate. After consulting their general practitioner, patients were administered a demographic information questionnaire, a shoulder pain and disability index (SPADI) and a short form 36 (SF-36) health survey. Subsequent review in a clinic held by a rheumatology registrar every 2 weeks was undertaken.


RESULTS
The sex- and age-standardized incidence of shoulder pain was 9.5 per 1000 (95% confidence interval 7.9 to 11.2 per 1000). Rotator cuff tendinopathy was found in 85%, signs of impingement in 74%, acromioclavicular joint disease in 24%, adhesive capsulitis in 15% and referred pain in 7%. On the SPADI the mean disability subscale score was 45 (95% confidence interval 41 to 50) and the mean pain score was 58 (95% confidence interval 53 to 62) (range 0 to 100). Evaluation of general health status using the SF-36 showed the difference between population norms and those with shoulder pain was significant in six of the eight domains, being especially marked (greater than 20 point reduction) for emotional role, physical function and physical role.


CONCLUSIONS
Shoulder pain, most commonly due to rotator cuff tendinopathy, is associated with significantly reduced health when measured by both specific and generic means. Effort towards prevention and early intervention in these complaints is warranted.
Ostör
A J K
AJ
Rheumatology Research Unit, Box 194, Addenbrooke's Hospital, Hills Road, Cambridge CB2 2QQ, UK. andrew.ostor@addenbrookes.nhs.uk
Richards
C A
CA
Prevost
A T
AT
Speed
C A
CA
Hazleman
B L
BL
D000173:Acromioclavicular Joint / Q000503:physiopathology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002062:Bursitis / Q000150:complications / Q000503:physiopathology; D004185:Disability Evaluation; D005260:Female; D006304:Health Status; D006801:Humans; D007592:Joint Diseases / Q000150:complications / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D017006:Rotator Cuff / Q000503:physiopathology; D019534:Shoulder Impingement Syndrome / Q000150:complications / Q000503:physiopathology; D020069:Shoulder Pain / Q000209:etiology / Q000503:physiopathology*