Department of Physical Medicine and Rehabilitation, Oslo University Hospital Ullevål, Oslo, Norway.
BMC Musculoskelet Disord. 2010 Oct 15;11:239. doi: 10.1186/1471-2474-11-239.
Shoulder pain is common with rotator cuff disease as the most frequently used clinical diagnosis. There is a wide range of treatment options for this condition, but limited evidence to guide patients and clinicians in the choice of treatment strategy. The purpose of this study was to investigate possible prognostic factors of short-term outcome after corticosteroid injection for rotator cuff disease.
We performed analyses of data from 104 patients who had participated in a randomized controlled study. Socio-demographic, clinical and radiographic baseline factors were assessed for association with outcome at six-weeks follow-up evaluated by Shoulder Pain and Disability Index (SPADI) and patient perceived outcome. Factors with significant univariate association were entered into multivariate linear and logistic regression analyses.
In the multivariate analyses; a high SPADI score indicating pain and disability at follow-up was associated with decreasing age, male gender, high baseline pain and disability, being on sick-leave, and using regular pain medication. A successful patient perceived outcome was associated with not being on sick-leave, high active abduction, local corticosteroid injection and previous cortisone injections. Structural findings of rotator cuff tendon pathology on MRI and bursal exudation or thickening on ultrasonography did not contribute to the predictive model.
Baseline characteristics were associated with outcome after corticosteroid injection in rotator cuff disease. Sick-leave was the best predictor of poor short-term outcome.
Clinical trials NCT00640575.
肩痛是肩袖疾病的常见症状，也是最常用的临床诊断。对于这种疾病有广泛的治疗选择，但有限的证据可以指导患者和临床医生选择治疗策略。本研究的目的是探讨皮质类固醇注射治疗肩袖疾病短期疗效的可能预测因素。
我们对参加随机对照研究的 104 名患者的数据进行了分析。评估了社会人口统计学、临床和影像学基线因素与 6 周随访时的结果（通过肩痛和残疾指数（SPADI）和患者感知结果评估）之间的关系。对具有显著单因素相关性的因素进行了多元线性和逻辑回归分析。
在多元分析中；随访时 SPADI 评分较高（表示疼痛和残疾）与年龄下降、男性性别、基线时疼痛和残疾程度较高、休病假和经常使用止痛药有关。患者感知结果良好与不休病假、主动外展度高、局部皮质类固醇注射和以前的皮质类固醇注射有关。MRI 显示肩袖肌腱病理结构和超声显示滑囊渗出或增厚等结构发现并不能为预测模型提供依据。
基线特征与肩袖疾病皮质类固醇注射后的结果相关。休病假是短期预后不良的最佳预测因素。
临床试验 NCT00640575。
