title: Rheumatoid shoulder assessed by ultrasonography: prevalence of abnormalities and associated factors.
abstract: BACKGROUND
  The shoulder involvement in rheumatoid arthritis (RA) is common. It can be subclinical and compromise the function of the upper limb. Musculoskeletal ultrasonography can detect subclinical abnormalities in rheumatoid shoulder. Our aim was to assess the prevalence of ultrasound abnormalities in rheumatoid shoulder, and investigate their association with different parameters.
  
  
  METHODS
  Cross-sectional study including 37 patients with RA, meeting the ACR/EULAR 2010 classification criteria, who were enrolled during a month. A questionnaire with sociodemographic, clinical and laboratory data was filled in for all patients. Ultrasound evaluation was performed by a single experienced operator. For each patient, both of shoulders were evaluated.
  
  
  RESULTS
  Mean age was 50 years with female predominance. Median disease duration of RA was 7.5 years. All patients had a seropositive form of RA. Mean clinical DAS28 was 5.1. Mean HAQ was 1.2. Thirty-one (83.8%) patients had involvement of the shoulder: unilateral in 9(24.3%) cases and bilateral in 22(59.5%) cases. Synovitis was found in 16(43.2%) patients with Doppler in 4 (10.8%) cases. Sub-acromial bursitis was noted in 14 (37.8%) cases and the effusion in 20 (54.1%). Synovitis was noted especially in elderly individuals (p: 0.01). The Doppler was visualized in elderly patients (p: 0.01), with a shorter disease duration (p: 0.02) and with a high SDAI (p: 0.006). US inflammatory findings in anterior recess of glenohumeral joint were linked to a higher synovial index (p: 0.03) and a higher level of rheumatoid factor (p: 0.01).
  
  
  CONCLUSIONS
  59.5% of our RA patients had bilateral involvement of the shoulder which was related to the disease activity. Ultrasound should be a systematic tool to look for the involvement of this joint in RA patients.
authors: Rheumatology Departement, El Ayachi Hospital, Ibn Sina University hospital, Sale, Morocco.
authors: Imane
authors: I
authors: Elbinoune
authors: Rheumatology Departement, El Ayachi Hospital, Ibn Sina University hospital, Sale, Morocco; Laboratory of Biostatistics, Clinical and Epidemiological Research (LBRCE), Faculty of Medicine and Pharmacy, Ibn Sina University Hospital, Rabat, Morocco; LIPROS-URAC30, Mohammed V Souissi University, Rabat, Morocco.
authors: Bouchra
authors: B
authors: Amine
authors: Rheumatology Departement, El Ayachi Hospital, Ibn Sina University hospital, Sale, Morocco.
authors: Moudjibou
authors: M
authors: Wabi
authors: Rheumatology Departement, El Ayachi Hospital, Ibn Sina University hospital, Sale, Morocco; Laboratory of Biostatistics, Clinical and Epidemiological Research (LBRCE), Faculty of Medicine and Pharmacy, Ibn Sina University Hospital, Rabat, Morocco; LIPROS-URAC30, Mohammed V Souissi University, Rabat, Morocco.
authors: Hanan
authors: H
authors: Rkain
authors: Rheumatology Departement, El Ayachi Hospital, Ibn Sina University hospital, Sale, Morocco.
authors: Souad
authors: S
authors: Aktaou
authors: Rheumatology Departement, El Ayachi Hospital, Ibn Sina University hospital, Sale, Morocco; Laboratory of Biostatistics, Clinical and Epidemiological Research (LBRCE), Faculty of Medicine and Pharmacy, Ibn Sina University Hospital, Rabat, Morocco; LIPROS-URAC30, Mohammed V Souissi University, Rabat, Morocco.
authors: Najia
authors: N
authors: Hajjaj-Hassouni
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging* / Q000473:pathology; D002062:Bursitis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012785:Shoulder Joint; D013585:Synovitis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology; D013997:Time Factors; D018608:Ultrasonography, Doppler / Q000379:methods
keywords: Rheumatoid arthritis; shoulder; ultrasonography