By Amy L. Sutton

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It is sometimes the first sign of giant cell arteritis, a disease of the arteries characterized by headaches, inflammation, weakness, weight loss, and fever. 19 Arthritis Sourcebook, Third Edition Polymyositis: This rheumatic disease causes inflammation and weakness in the muscles. The disease may affect the whole body and cause disability. Psoriatic arthritis: This form of arthritis occurs in some patients with psoriasis, a scaling skin disorder. Psoriatic arthritis often affects the joints at the ends of the fingers and toes and is accompanied by changes in the fingernails and toenails.

In scleroderma, there is an abnormal and excessive production of collagen (a fiber-like protein) in the skin and internal organs. Spondyloarthropathies: This group of rheumatic diseases principally affects the spine. One common form—ankylosing spondylitis— also may affect the hips, shoulders, and knees. The tendons and ligaments around the bones and joints become inflamed, resulting in pain and stiffness. Ankylosing spondylitis tends to affect people in late adolescence or early adulthood. Reactive arthritis, sometimes called Reiter syndrome, is another spondyloarthropathy.

When the rotator cuff tendon becomes inflamed and thickened, it may get trapped under the acromion. Squeezing of the rotator cuff is called impingement syndrome. Bursitis, or inflammation of the bursa sacs that protect the shoulder, may accompany tendonitis and impingement syndrome. Inflammation caused by a disease such as rheumatoid arthritis may cause rotator cuff tendonitis and bursitis. Sports involving overuse of the shoulder and occupations requiring frequent overhead reaching are other potential causes of irritation to the rotator cuff or bursa and may lead to inflammation and impingement.

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