Salek K M, Mannan M, Chowdhury A Z, Haque M A, Kaiser M S, Nabi S, Ferdousee R A, Paul B K, Ahmed S M, Khan M, Begum M
Department of Physical Medicine, Bangabandhu Sheikh Mujib Medical University, Shahbagh, Dhaka, Bangladesh.
Mymensingh Med J. 2011 Jan;20(1):16-21.
Painful shoulder is a common painful condition among patients. Apart from acute traumatic lesions such as fractures, dislocations, contusions, sprains and ruptured tendons, 85 to 90% of painful shoulders are due to adhesive capsulitis, acute or chronic calcific tendinitis, bursitis, bicipital tendinitis and lesions of the musculotendinous cuff. Arthritis is the cause of less than 5% of painful shoulders. For evaluating conditions of shoulder joint, X-ray has been regarded as only method of choice for long time. Magnetic resonance imaging (MRI) is an alternative procedure but the cost limits its utilization especially in Bangladesh. Ultrasonography is an effective imaging modality in the evaluation of both rotator and non-rotator cuff disorders. Because of low cost and availability, it can be an alternative procedure for the diagnosis of painful shoulder. The present study was conducted to assess ultrasonography as a useful modality in evaluating cases of shoulder pain and to compare the findings with X-ray findings. Thirty two patients with shoulder pain were evaluated by X-ray and Ultrasonography (USG). Clinical diagnosis was done for correlation. To identify the cause of shoulder pain, 100% patients were found normal in plain X-ray. On Ultrasonography (USG) 12.5% patients had displaced long head of biceps, 21.9% had biceps tendinitis, and 3.1% had bursitis. In the assessment of shoulder pathology, USG had a sensitivity of 73.3%, specificity of 88.2%, Positive predictive value (PPV) of 84.6%, Negative predictive value (NPV) of 78.9% and an accuracy of 81.3%. USG is a useful modality for evaluation the shoulder joint in case of painful shoulder even plain X-ray is non conclusive.
肩部疼痛是患者中常见的疼痛病症。除了骨折、脱位、挫伤、扭伤和肌腱断裂等急性创伤性损伤外，85%至90%的肩部疼痛是由粘连性关节囊炎、急慢性钙化性肌腱炎、滑囊炎、肱二头肌肌腱炎和肌腱袖损伤引起的。关节炎导致的肩部疼痛不到5%。长期以来，X线一直被视为评估肩关节状况的唯一选择方法。磁共振成像（MRI）是一种替代方法，但成本限制了其应用，尤其是在孟加拉国。超声检查是评估旋转肌袖和非旋转肌袖疾病的一种有效成像方式。由于成本低且易于获得，它可以作为诊断肩部疼痛的替代方法。本研究旨在评估超声检查作为评估肩部疼痛病例的一种有用方式，并将结果与X线检查结果进行比较。对32例肩部疼痛患者进行了X线和超声检查（USG）。进行临床诊断以作对照。为了确定肩部疼痛的原因，发现100%的患者X线平片正常。在超声检查（USG）中，12.5%的患者肱二头肌长头移位，21.9%的患者患有肱二头肌肌腱炎，3.1%的患者患有滑囊炎。在评估肩部病变时，超声检查的敏感性为73.3%，特异性为88.2%，阳性预测值（PPV）为84.6%，阴性预测值（NPV）为78.9%，准确率为81.3%。即使X线平片无定论，超声检查仍是评估肩部疼痛时肩关节的一种有用方式。
