Popular wisdom recognizes that rheumatic symptoms occur more commonly in the elderly than in the young. Many of these symptoms have been attributed, perhaps incorrectly, to osteoarthritic changes casually discovered by roentgenography. The remainder are chiefly ascribed to rheumatoid arthritis and to polymyalgia rheumatica. The former, believed to attain its peak incidence in the fourth and fifth decades, remains with those afflicted throughout their remaining years. As no appreciable mortality accompanies this disorder, the number of affected persons increases steadily.
After the age of 60, rheumatoid arthritis takes on new characteristics. Among these characteristics is painful involvement of the shoulder girdle, which simulates the shoulder-hand syndrome when hands are also involved.1 The frequent occurrence of peritendinitis in the shoulders of patients otherwise afflicted by interphalangeal osteoarthritis of the fingers has been reported. These findings have recently been corroborated (Jack Waxman, MD, unpublished data, 1974). This concatenation of symptoms, each