Background and Purpose Musculoskeletal problems including shoulder pain are common in the general population and are often cited as reasons for physician visits. Although many risk factors for shoulder pain are postulated, the effects of shoulder pain on functional level and perceived quality of life are poorly characterized in older adults. In this study, we set out to determine the prevalence and impact of shoulder symptoms and dysfunction in an older adult veteran population. Methods A chart review, cross-sectional survey, and examination were performed. A sample of 93 individuals, age >60, were recruited from a primary clinic outpatient waiting room at the Clement J. Zablocki VA Medical Center in Milwaukee, WI. Patients were asked about shoulder symptoms and self-assessed health (SAH), and completed the Stanford Modified Health Assessment Questionnaire (MHAQ). A series of 3 shoulder maneuvers were used to assess shoulder mobility and pain. The presence of diabetes and statin use was documented. A more thorough chart review was performed on individuals who reported shoulder pain and disability. Results Severe shoulder pain was common in the study group, reported by 31% of all participants. Functional limitation measured by the MHAQ and answering “yes” to greater difficulty performing daily tasks was associated with reduced internal rotation, which was present in almost 36% of all participants. Symptoms were often bilateral. No statistically significant risk factors emerged in this small sample, but suggestive trends were apparent. Interestingly, few patients reported discussing these problems with their providers, and shoulder-related problems were documented in only 10% of corresponding problem lists of symptomatic patients. Conclusions With an aging population, the high prevalence of shoulder pain may have considerable impact on public health. It will become increasingly important to define risk factors, delineate etiologies, and devise new management strategies for patients with symptomatic shoulder disease.

Background Despite high prevalence, progress in calcium pyrophosphate deposition (CPPD) has been limited by poor awareness and absence of validated approaches to study it in large datasets. Objectives We aimed to determine the accuracy of administrative codes for the diagnosis of CPPD as a foundational step for future studies. Methods We identified all patients with an International Classification of Diseases-9-common modification (ICD-9-CM) code for chondrocalcinosis (712.1–712.39) or pseudogout/other disorders of mineral metabolism (275.49), and randomly selected a comparison group with gout (274.00–03 or 274.8–9), or rheumatoid arthritis (714.0) from 2009–2011 at a VA medical center. Each patient was categorized as having definite, probable, possible CPPD or absence of CPPD based on the McCarty and Ryan criteria using chart abstracted data including crystal analysis, radiographs, and arthritis history. Results 249 patients met the clinical gold standard criteria for CPPD based on medical records, while 48 patients met definite criteria, 183 probable, and 18 met possible criteria. The accuracy of administrative claims with a code of 712 or 275.49 for definite or probable CPPD was: 98% sensitivity (95% CI, 96%–99%), 78% specificity (74%–83%), 91% positive predictive value and 94% negative predictive value. Conclusions A single administrative code 275.49 or 712 accurately identifies patients with CPPD with a positive predictive value of 91%. These findings suggest that administrative codes have strong clinical accuracy and merit further validation to allow adoption in future epidemiologic studies of CPPD.