The shoulder joints of 105 patients with rheumatoid arthritis were examined. The patients were on average 62 years old and their mean RA duration 17 years. Ninety-six patients (91%) reported shoulder problems. Thirty-three patients had actual severe painful shoulder disability. The acromioclavicular joint was clinically tender in 36 shoulders and subacromial hypertrophic bursitis was recorded for 22 shoulders. One hundred and sixteen shoulders in 61 of the patients with shoulder pain were examined radiologically and classified according to the Larsen system. With increasing duration of the RA there was a progress of destructive changes and a decrease in the range of motion, indicating that intervention with surgical procedures may be warranted.