Tsui Sammi Sin Mei, Leong Hio Teng, Leung Vivian Yee Fong, Ying Michael, Fu Siu Ngor
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong (SAR), China.
Department of Radiology and Imaging, Prince of Wales Hospital, Shatin, Hong Kong (SAR), China.
J Shoulder Elbow Surg. 2017 May;26(5):774-780. doi: 10.1016/j.jse.2016.09.041. Epub 2017 Jan 10.
Supraspinatus tendinopathy is one of the common causes of subacromial pain syndrome (SAPS) in overhead athletes. Changes in tendon vascularity have been reported in painful tendons; however, the prevalence and distribution have not been investigated in young overhead athletes.
We conducted a cross-sectional study of 47 overhead athletes (male, 31; female, 16) aged 18 to 36 years with SAPS for >3 months. A sonographer graded the severity of the tendinopathy and area of vascularization. Ultrasound imaging was used to measure supraspinatus tendon thickness, vascularity, and resting subacromial space. A self-written program was used to semiquantify the intensity of vascularity, expressed as the vascular index.
The majority (87.2%) of the participants had signs of tendinopathy in the supraspinatus tendon, and 40 (85.1%) of the tendinopathic tendons had vascularity. The majority (66.0%) of the vascularized subjects presented with minimal increase in vascularity, and 19.1% had moderate to severe vascularization. Most (79.2%) of the vascularization was observed in the pericortical region. The vascular index was negatively correlated with the resting subacromial space in male athletes with a reduced subacromial space (ρ = -0.63; P = .038).
Of overhead athletes with SAPS, 87.2% had supraspinatus tendinopathy with minimal to moderate vascularization, with the majority of vascularization occurring in the pericortical region. In male athletes with a reduced subacromial space, greater vascularity in the supraspinatus tendon was associated with a smaller resting subacromial space.
冈上肌腱病是从事过顶运动的运动员肩峰下疼痛综合征（SAPS）的常见病因之一。已有报道称疼痛肌腱的血管分布会发生变化；然而，年轻的从事过顶运动的运动员中血管分布的患病率和分布情况尚未得到研究。
我们对47名年龄在18至36岁、患有SAPS超过3个月的从事过顶运动的运动员（男性31名，女性16名）进行了一项横断面研究。一名超声检查人员对肌腱病的严重程度和血管化区域进行分级。使用超声成像测量冈上肌腱厚度、血管化程度和静息肩峰下间隙。使用一个自编程序对血管化强度进行半定量，以血管指数表示。
大多数参与者（87.2%）的冈上肌腱有肌腱病迹象，40条（85.1%）患有肌腱病的肌腱有血管化。大多数血管化的受试者（66.0%）血管化仅有轻微增加，19.1%有中度至重度血管化。大部分血管化（79.2%）出现在皮质周围区域。在肩峰下间隙减小的男性运动员中，血管指数与静息肩峰下间隙呈负相关（ρ = -0.63；P = 0.038）。
在患有SAPS的从事过顶运动的运动员中，87.2%患有冈上肌腱病，血管化程度为轻度至中度，大部分血管化发生在皮质周围区域。在肩峰下间隙减小的男性运动员中，冈上肌腱血管化程度越高，静息肩峰下间隙越小。
