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Abstract This study was carried out on 59 patients complaining f:m:m shoulder pain lifted into two groups: 1. Group I: Thirty patients complaining from shoulder pain with exclusion of previous trauma or chronic inflammatory disease. 2. Group II: Twenty nine patients previously diagnosed as rheumatoid arthritis and fulfilled the ACR criteria of rheumatoid arthritis complained of shoulder pain. Careful physical examination was done for both groups using special tests for !Ilgement syndrome, tendon lesion, and acromioclavicular lesions. Plain x-ray lder both AP and axial views was done, and finally ultrasound examination of ihoulder region was done for both groups. Our results showed that ultrasound is more accurate in detection of the cause of llder pain where physical examination couldn’t differentiate tendinitis from tear, ,dn’t detect the type of tear whether complete or partial and couldn’t differentiate exact cause of acromioclavicular pathology whether inflammatory or enerative. it also neglected 12 case of glenohumeral effusion detected by asound. Ultrasound as detected by our results shown to have higher sensitivity and ’lficity than physical examination in detecting shoulder lesions. Ultrasound also shown to be more accurate in detection of shoulder pathology plain radiography as plain x-ray couldn’t detect tendon lesions, SA-SD bursitis, J, GHJ lesions or impingement, ultrasound also is more sensitive than plain lography in detection of erosions, osteophytes and cortical bone irregularities. Moreover, there was also significant difference between both groups regarding ator cuff tears, bicipital tendinitis, GH and AC effusion; impingement, AC leneration and humeral cortical irregularities denoting that rheumatoid arthritis ect both bony, articular, and soft tissue structures of the shoulder region. |