First Department of Neurology, National and Kapodistrian University of Athens, "Aeginition" University Hospital of Athens, Greece.
2nd Regional Health Administrations of Piraeus and Aegean, 1st Health Care Center of Peristeri, Athens, Greece.
J Musculoskelet Neuronal Interact. 2023 Jun 1;23(2):263-280.
This study aimed to review shoulder clinical and imaging findings in Parkinson's disease (PD), focusing on the significance of timely diagnosis and management of shoulder dysfunction in PD for the prevention of shoulder-related complications. A bibliographical search was employed, using "Parkinson's" and "Shoulder Dysfunction" as keywords. A Magnetic Resonance Imaging, twenty clinical and three US studies were selected as relevant to shoulder dysfunction in PD. Shoulder pain, frozen shoulder and arm swing asymmetry are the most prevalent clinical findings that may antedate cardinal PD symptoms. Supraspinatus tendon thickening or tearing, adhesive capsulitis, acromioclavicular changes, bursa and joint effusion are common shoulder MRI or US-detected abnormalities in mild or severe PD stages. Fractures due to falls or osteoporosis are secondary shoulder pathologies. Higher ipsilateral Unified Parkinson's Disease Rated Scale (UPDRS) scores, rigidity, tremor, and bradykinesia are associated with frozen shoulder. Disease duration, rigidity, and falls are contributing factors for tendon tears, adhesive capsulitis, and fractures respectively. When common symptoms, such as pain and frozen shoulder are unaccounted for by orthopedic or other local primary pathology, they might indicate underlying early PD. Timely diagnosis and appropriate early management of PD may, in turn, help delay or prevent shoulder-related complications.
本研究旨在回顾帕金森病（PD）的肩部临床和影像学表现，重点关注及时诊断和管理 PD 患者肩部功能障碍对预防与肩部相关并发症的重要性。采用文献检索，以“帕金森”和“肩部功能障碍”为关键词。选择了 20 项临床研究和 3 项超声研究，这些研究与 PD 患者的肩部功能障碍相关。肩部疼痛、冻结肩和手臂摆动不对称是最常见的临床发现，可能早于 PD 的主要症状。肩袖肌腱增厚或撕裂、粘连性肩关节囊炎、肩锁关节改变、滑囊和关节积液是轻度或重度 PD 阶段常见的肩部 MRI 或超声检测异常。因跌倒或骨质疏松引起的骨折是继发性肩部病变。同侧统一帕金森病评定量表（UPDRS）评分较高、僵硬、震颤和运动迟缓与冻结肩有关。病程、僵硬和跌倒分别是肌腱撕裂、粘连性肩关节囊炎和骨折的促成因素。当疼痛和冻结肩等常见症状不能用骨科或其他局部原发性疾病来解释时，它们可能表明存在早期 PD。及时诊断和适当的早期 PD 管理反过来可能有助于延迟或预防与肩部相关的并发症。
