Radiology, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland.
Faculty of Medicine, University of Zurich, Zurich, Switzerland.
Eur Radiol. 2019 Dec;29(12):6416-6424. doi: 10.1007/s00330-019-06237-1. Epub 2019 Jun 17.
This study was conducted in order to determine the predictive value of MR arthrography findings for pain relief after glenohumeral corticosteroid injection.
This study prospectively enrolled 212 patients (mean age 51.4 years; range 15-90) who underwent fluoroscopy-guided glenohumeral corticosteroid injection. All patients received MR arthrography of the shoulder less than 3 months prior to the infiltration and returned questionnaires which assessed patients' shoulder pain using the 11-point numeric rating scale (NRS), covering a 1-month follow-up period. MR arthrograms were retrospectively assessed for abnormalities of the rotator cuff, long biceps tendon, glenohumeral bone, cartilage, and labrum as well as for synovitis, bursitis, and signs of adhesive capsulitis. MR arthrography findings were compared to patients' NRS change using the Mann-Whitney U and Kruskal-Wallis tests for univariate analysis and multiple linear regression for multivariate analysis.
Pain reduction of ≥ 2 points was considered to represent clinically relevant improvement, which was seen in 71% of patients 1 week and in 74% of patients 1 month after glenohumeral injection. Univariate analysis of MR findings showed that signs of adhesive capsulitis and an intact labrum were associated with significantly higher NRS reductions after 1 month in comparison to patients without these findings (median 4 vs. 3, p = 0.007 and 4 vs. 2, p = 0.003, respectively). Multivariate analysis proved both factors to be independent predictors of improved outcome after 1 month (beta = 0.176, p = 0.039 and beta = 0.212, p = 0.001, respectively).
Glenohumeral corticosteroid injections for pain relief have a high success rate with 74% of patients reporting clinically relevant improvement after 1 month. Signs of adhesive capsulitis and an intact labrum on MR arthrography are independent predictors of a better outcome.
• Seventy-four percent of patients report clinically relevant improvement 1 month after glenohumeral corticosteroid injection. • Signs of adhesive capsulitis and an intact labrum on MR arthrography are independent predictors of a high pain level decrease.
本研究旨在确定磁共振关节造影术在评估肱盂关节皮质类固醇注射后疼痛缓解方面的预测价值。
本研究前瞻性纳入 212 例（平均年龄 51.4 岁；15-90 岁）接受透视引导下肱盂关节皮质类固醇注射的患者。所有患者在浸润前不到 3 个月均行肩关节磁共振关节造影术，并在 1 个月的随访期内返回评估患者肩关节疼痛的问卷，使用 11 点数字评分量表（NRS）进行评估。磁共振关节造影术结果回顾性评估肩袖、长肱二头肌肌腱、肱盂骨、软骨和盂唇的异常，以及滑膜炎、滑囊炎和粘连性关节囊炎的征象。采用 Mann-Whitney U 检验和 Kruskal-Wallis 检验进行单变量分析，多元线性回归进行多变量分析，比较磁共振关节造影术结果与患者 NRS 变化。
疼痛减轻≥2 分被认为是临床相关的改善，在肱盂关节注射后 1 周和 1 个月，分别有 71%和 74%的患者出现这种情况。磁共振发现的粘连性关节囊炎和完整的盂唇征象与 1 个月后 NRS 降低显著相关（中位数 4 分比 3 分，p=0.007 和 4 分比 2 分，p=0.003）。多变量分析证实这两个因素均为 1 个月后改善结局的独立预测因素（β=0.176，p=0.039 和 β=0.212，p=0.001）。
肱盂关节皮质类固醇注射缓解疼痛成功率高，74%的患者在 1 个月后报告有临床相关的改善。磁共振关节造影术上粘连性关节囊炎和完整的盂唇征象是更好结局的独立预测因素。
肱盂关节皮质类固醇注射后 1 个月，74%的患者报告有临床相关的改善。
磁共振关节造影术上粘连性关节囊炎和完整的盂唇征象是疼痛程度降低的高预测因素。
