Abstract
A clincco-statistic observation was made on a total of 181 patients of so-called stiff shoulder reported to the author's clinic in the past 5 years. They occupied 1.36% of the total 13, 226 outpatients during the same period. Onset of the disease appears to be predominant during the seasons from spring to early summer. In the author's clinic, most of the patients reported in summer. Contrary to the other reports, males occupied only 46.4% and females 53.6%. As for the age of patients at the time of primary consultation, those on fifties were predominant. Those below 45 years were more among males and those above 46 were more among females. Those affected of both shoulders were 18.2%, right shoulder alone 44.8% and the left shoulder 37.0%. When this difference of right and left was observed by the difference of sex, the rate of males and females affected of both shoulders was 2: 1, while those suffered from only one side stiff shoulder were slightly more among females. The main complication noted was the disorder in the region of cervical vertebra necessitating detailed studies on this problem in future. Only 10 of them were found to have trauma which was a simple contusion in all cases.
As for clinical symptoms, only few of them experienced the sudden attack of severe pain, and all cases followed chronic disease course. Numerous tender points were recognized on the regions of processus coracoides, anterior articular cleft and major tuber. As for motility, abduction and outward rotation were markedly disturbed indicating the presence of strong contracture at the positions of adduction and inside rotation.
Main X-ray findings were the atrophy of bone on the region of major tuber (80.0%) and dark shadows observed on the part of the attachment of m. supra spinam tendon (48.8%) . These changes, however, are not necessarily characteristic to the so-called stiff shoulder. Arthrograms indicated the presence of the atrophy of articular capsule.
Physicotheraphy, administration of antirheumatic preparations or intraarticular injections of steroid hormones were not so much effective. The use of abduction splint is highly recommended for the alleviation of pain as well as for the prevention of reflexive muscular contracture.
