抄録
(Purpose)We know about the destruction of a shoulder joint by rheumatoid arthritis(RA), but this report concerns a case which was complicated by a posterior dislocation.
(Case)A 73-year-old female underwent treatment for RA in the last decade. In July 1994, she began to have pain in her left shoulder joint and found it difficult to raise her left arm. She consulted a clinic nearby, where she was diagnosed with a posterior dislocation of the left shoulder joint. Then she was referred to our hospital in February 1995. Her left shoulder joint was such that the humeral head contacted with the rear part of the acrmion, and the ROM was significantly limited. The posterior dislocation was confirmed on two-directional X-rays. As conservative therapy led nowhere, we opted for a total shoulder replacement(TSR) in November 1995. Deformity of the humeral head, destruction of the posterior part of the glenoid, and a torn supraspinatus were observed. Her JOA score preoperatively had been 22 but improved to 59 nine months after the operation.
(Discussion)Destruction of shoulder joints by RA is common, but no reports have appeared on a pathologic posterior dislocation. There was no traumatic mechanism for this dislocation, thus leading us to consider arthral destruction as being responsible for the posterior dislocation of the shoulder joint. We opted for a TSR as treatment hoping to get rid of the pain and improve ADL.
