Treatment of the shoulder-hand syndrome with corticosteroids.

The incidence of the shoulder-hand syndrome is unknown. Certainly the condition is less common since early mobilization of patients after myocardial infarction was instituted 10 to 15 years ago (Graham and Rosen, 1962; Woodhouse, 1968). However, the condition has received scant attention in the British literature (Plewes, 1956) and on the basis of published series of patients would seem to be rather commoner in North America and Europe (Steinbrocker and Argyros, 1958; Johnson and Pannozzo, 1966; Pak, Martin, Magness, and Kavanaugh, 1970). The cause of the condition has not been clearly determined and its treatment remains empirical. Various authors haverecommended intensive physical therapy (Johnson and Pannozzo, 1966), sympathetic blockade, or systemic corticosteroids (Russek, 1958), but the assessment of the results is difficult since partial or complete remission of the condition may occur spontaneously. It therefore seemed valuable to report our findings in three patients with the shoulder-hand syndrome treated with systemic corticosteroids.