Serviço de Imagiologia Geral, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Centro Académico de Medicina de Lisboa, Lisbon, Portugal.
Serviço de Reumatologia e Doenças Ósseas Metabólicas, Hospital de Santa Maria, CHULN, Lisbon, Portugal.
J Clin Ultrasound. 2023 Jun;51(5):837-844. doi: 10.1002/jcu.23436. Epub 2023 Jan 30.
To find ultrasound prognostic factors for shoulder pain.
This was an observational, prospective study, comparing the evolution of ultrasound findings with clinical outcomes, in patients with shoulder pain. Data were collected in two appointments, from February 2018 to March 2021. Two-tailed non-parametric statistics were used, and p values <0.05 were considered significant.
A total of 79 participants were included in this study (median age 59 years, range 24-70, 61 women). A positive Doppler signal on tendons (p = 0.002) and absent tendon heterogeneity (p = 0.01) were associated with the patient's self-reported improvement. Tendon calcifications with poorly defined contours (p = 0.03) and sparse distribution (p = 0.001) were associated with VAS improvement. A reduction in the number of calcifications (p = 0.004), in the supraspinatus tendon thickness (p = 0.01), in subacromial effusions (p = 0.03), and in color Doppler grade (p = 0.02), between initial and follow-up exams, was found in patients with an improved DASH outcome.
A positive Doppler signal on shoulder tendons can be a marker for a better prognosis in shoulder pain. Poorly defined and sparsely distributed calcifications can also indicate a better course of the disease.
寻找与肩痛相关的超声预后因素。
这是一项观察性、前瞻性研究,比较了有肩痛患者的超声表现与临床结局的演变。数据于 2018 年 2 月至 2021 年 3 月在两次就诊中收集。采用双侧非参数统计学,p 值 <0.05 被认为具有统计学意义。
本研究共纳入 79 名参与者(中位年龄 59 岁,范围 24-70 岁,61 名女性)。肌腱的阳性多普勒信号(p=0.002)和肌腱异质性缺失(p=0.01)与患者的自我报告改善相关。边界不清和稀疏分布的肌腱钙化(p=0.03)与 VAS 改善相关。在接受治疗的患者中,钙化数量减少(p=0.004)、冈上肌腱厚度变薄(p=0.01)、肩峰下囊积液减少(p=0.03)以及彩色多普勒分级降低(p=0.02)与 DASH 结局改善相关。
肩部肌腱的阳性多普勒信号可能是肩痛预后良好的标志。边界不清和稀疏分布的钙化也可能表明疾病的病程较好。