ArticleCureus2025
Predictors of Shoulder Pathology in Rheumatoid Arthritis: A Cross-Sectional Study.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundShoulder pain is a frequent but under‑recognized manifestation of rheumatoid arthritis (RA), contributing substantially to disability and impaired quality of life. High‑resolution musculoskeletal ultrasound (HRUS) offers sensitive detection of structural abnormalities, while the Shoulder Pain and Disability Index (SPADI) provides patient‑reported assessment of pain and function. However, the clinical and laboratory predictors of shoulder pathology and disability in RA remain incompletely defined.
methodsIn this cross‑sectional study, 105 RA patients presenting with shoulder pain were enrolled. All participants underwent HRUS evaluation of the affected shoulder(s) and completed the SPADI questionnaire. Baseline demographic and laboratory parameters were recorded. Binary logistic regression was used to identify predictors of abnormal HRUS findings and seropositivity, while linear regression analyses examined associations with SPADI total (SPADI‑T), pain (SPADI‑P), and disability (SPADI‑D) scores.
resultsAbnormal HRUS findings were present in 69 patients (65.7%). Logistic regression identified lower Hb (p=0.006, OR=0.01) and higher platelet (PLT) count (p=0.016, OR=1.16) as significant predictors of abnormal HRUS findings, with erythrocyte sedimentation rate (ESR) (p=0.010) and vitamin D deficiency (p=0.050) approaching significance. Higher ESR was also correlated with higher CRP. Linear regression demonstrated that longer disease duration, lower Hb, higher PLT count, elevated random blood sugar, and higher thyroid-stimulating hormone were predictors of worse SPADI‑T scores (R²=54.4%).
conclusionShoulder pathology in RA is multifactorial, with anemia, thrombocytosis, systemic inflammation, metabolic derangements, and vitamin D deficiency contributing to pain and disability. HRUS abnormalities are strongly linked to hematologic and metabolic markers, while functional impairment is influenced by both inflammatory and endocrine factors.
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