Service de Rhumatologie, CH de Cholet, Cholet, France.
Service de Rhumatologie, CHU Nantes, 1 Place Alexis Ricordeau, 44000, Nantes, France.
Eur Radiol. 2024 Jan;34(1):300-307. doi: 10.1007/s00330-023-09989-z. Epub 2023 Aug 4.
The objective of this study was to determine whether the presence of subacromial bursitis in patients with rotator cuff tendinopathy (RCT) was associated with a better outcome after ultrasound (US)-guided subacromial corticosteroid injection.
A single-center prospective study was performed including patients referred for subacromial injection to manage RCT. At baseline, all patients received an US-guided intra-bursal injection of betamethasone (1 ml). The primary endpoint was reduced pain 3 months (M3) after the procedure: a good responder was defined by a decrease in Visual Analogue Scale pain of more than 30%. Secondary endpoints included functional recovery assessed by the Oxford Shoulder Score (OSS) and clinical success at 6 weeks (W6). We also explored the association between good clinical response and other factors, such as US or X-ray features.
One hundred patients were included and 49 presented with subacromial bursitis. At M3, 60% of patients (54/100) were considered good responders. The rate of good responders did not differ between the bursitis and non-bursitis groups (p = 0.6). During follow-up, OSS improved over time whether bursitis was present or not. We did not find any US or X-ray features significantly associated with a favorable clinical outcome.
The presence of subacromial bursitis did not influence clinical outcomes at 3 months post-subacromial injection in patients suffering from RCT.
The presence of subacromial bursitis did not influence clinical outcomes at 3 months post-subacromial corticosteroid injection in patients with rotator cuff tendinopathy. For patient management, looking for ultrasonographic signs of bursitis does not appear relevant for the indication of the injection.
• Ultrasound-guided subacromial corticosteroid injections led to a significant improvement in 60% of patients suffering from rotator cuff tendinopathy. • The presence of subacromial bursitis was not associated with better improvement at 3 months post-injection. • Except for the Minnesota score referring to job satisfaction, we did not find any baseline clinical, X-ray, or ultrasound characteristics associated with a successful outcome.
本研究旨在确定肩袖肌腱病（RCT）患者中存在滑囊炎是否与超声（US）引导下肩峰下皮质类固醇注射后的更好结果相关。
进行了一项单中心前瞻性研究，包括因 RCT 而行肩峰下注射的患者。在基线时，所有患者均接受了 betamethasone（1ml）的 US 引导下腔内注射。主要终点是治疗后 3 个月（M3）疼痛减轻：通过视觉模拟量表（VAS）疼痛减轻超过 30%来定义良好反应者。次要终点包括通过牛津肩评分（OSS）评估的功能恢复和 6 周（W6）时的临床成功。我们还探讨了良好临床反应与其他因素（如 US 或 X 射线特征）之间的关系。
共纳入 100 例患者，其中 49 例存在肩峰下滑囊炎。在 M3 时，60%的患者（54/100）被认为是良好反应者。滑囊炎组和非滑囊炎组之间的良好反应者比例无差异（p=0.6）。在随访期间，无论是否存在滑囊炎，OSS 均随时间而改善。我们没有发现任何 US 或 X 射线特征与良好的临床结局显著相关。
在 RCT 患者接受肩峰下注射后 3 个月时，肩峰下滑囊炎的存在并不影响临床结局。
在肩袖肌腱病患者接受肩峰下皮质类固醇注射后 3 个月时，肩峰下滑囊炎的存在并不影响临床结局。对于患者管理，寻找超声下滑囊炎的迹象似乎与注射指征无关。
• 超声引导下肩峰下皮质类固醇注射可使 60%的肩袖肌腱病患者显著改善。
• 肩峰下滑囊炎的存在与注射后 3 个月时的改善无关。
• 除了与工作满意度相关的明尼苏达评分外，我们没有发现任何基线临床、X 射线或超声特征与成功结局相关。
