Department of Physical Medicine and Rehabilitation, Jeonbuk National University Medical School, Jeonju, 54907, Korea.
Research Institute of Clinical Medicine of Jeonbuk National University - Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, 54907, Korea.
J Back Musculoskelet Rehabil. 2021;34(6):951-956. doi: 10.3233/BMR-200281.
Paralabral cysts are a rare cause of shoulder pain. Linear ultrasound transducers are often used for musculoskeletal evaluation and intervention. However, the use of linear transducer is limited when the target structure is located deep and blocked by bony barriers, as is the case of paralabral ganglion cysts.
This case report aims to describe a beneficial role of using a convex transducer on the evaluation and ultrasonography-guided intervention of paralabral cysts below the acromion.
Two patients visiting the outpatient clinic of Physical Medicine and Rehabilitation complained of severe pain during shoulder movement. Ultrasound scans with linear transducer detected rotator cuff lesions. Shoulder magnetic resonance imaging was done because of the persistent pain despite therapeutic interventions for the rotator cuff lesion, and confirmed paralabral cysts. Although a linear array transducer could not visualize the cystic lesion but could only perform suprascapular nerve block and intra-articular injection, the use of a convex array transducer improved the visualization of the cystic lesion which we treated using ultrasound-guided aspiration and intra-cystic injection. Visual analog scale and Shoulder Pain and Disability Index were checked to assess the treatment effect of each intervention. The intra-cystic injection with aspiration and intra-articular injection showed minimal to moderate improvement of pain score.
In pain related to shoulder movement, especially pain that continues despite appropriate treatment for rotator cuff lesions, ultrasound diagnosis of paralabral ganglion cysts using convex transducers will improve the diagnostic value and accuracy of intervention.
滑囊囊肿是引起肩部疼痛的罕见原因。线性超声换能器常用于肌肉骨骼评估和介入。然而，当目标结构位于深部且被骨性屏障阻挡时，如滑囊旁神经节囊肿，线性换能器的使用就会受到限制。
本病例报告旨在描述凸阵换能器在评估和超声引导下治疗肩峰下滑囊囊肿中的有益作用。
两名到物理医学与康复科门诊就诊的患者主诉肩部运动时疼痛剧烈。线性换能器的超声扫描发现肩袖病变。尽管针对肩袖病变进行了治疗，但疼痛仍持续存在，因此进行了肩部磁共振成像检查，结果证实为滑囊旁囊肿。尽管线性换能器无法显示囊性病变，但可以进行肩胛上神经阻滞和关节内注射，而凸阵换能器的使用提高了对囊性病变的可视化程度，我们采用超声引导下抽吸和囊内注射对其进行了治疗。使用视觉模拟评分法和肩痛和残疾指数来评估每种干预措施的治疗效果。囊内抽吸和关节内注射显示疼痛评分有轻微至中度改善。
在与肩部运动相关的疼痛中，尤其是在针对肩袖病变进行适当治疗后仍持续存在的疼痛中，使用凸阵换能器进行滑囊旁神经节囊肿的超声诊断将提高诊断价值和介入的准确性。
