Laterality and incidence of adhesive capsulitis of the shoulder and plantar fasciitis among rural Saudis in the Jeddah zone.

SIR, In western medical publications adhesive capsulitis ('frozen shoulder', 'shoulder-hand syndrome') is supposedly commoner on the left side,' perhaps related to the finding that in an appreciable number of cases of adhesive capsulitis there is a preceding episode of a silent or overt cardiac infarct. The laterality and incidence of this condition and of plantar fasciitis were investigated among rural Saudis in a newly opened government general hospital in the Jeddah zone to see if the findings correlated with those in the West. A significant right sided preponderance in clinical symptoms of adhesive capsulitis2 3 and a significant left sided preponderance of plantar fasciitis was found among 6000 rural Saudis in the Jeddah zone, seen in the orthopaedic outpatients clinic in the first 18 months of the newly opened hospital. There were 375 presentations of clinical adhesive capsulitis from 369 patients (201 male, 168 female) with the complaint, an incidence of 6-15% (369/6000). The age range was 17-75 years, with an average age for the men of 43 and for the women of 42. The disorder was bilateral in six patients (three men, three women), right sided in 216, and left sided in 147-a significant right sided preponderance. Over the same period there were 84 presentations of clinical plantar fasciitis from 78 patients (63 male, 15 female), an incidence of 1-3%.4 Symptoms were left sided in 48 instances, right sided in 18, and bilateral in 12-a significant left sided preponderance. The age range was 28-60 years, with an average age for the men of 35 and for the women of 43. For those with bilateral involvement the average age was also 43 years. No ready explanation was found for the laterality observed in these conditions. Perhaps social customs are implicated. Further studies seem to be warranted.