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unresolved frozen shoulder: Are we really treating it? 未缓解的肩周炎:我们真的在治疗它吗?

Un-resolving frozen shoulder: Are we really treating it?

作者信息

Wagan Abrar Ahmed, Surahyo Paras

机构信息

Abrar Ahmed Wagan, MBBS, FCPS (Medicine), FCPS (Rheumatology), FACR. Associate Professor of Rheumatology, Indus Medical College, Tando Mohammad Khan, Pakistan.

Paras Surahyo, MBBS, FCPS (Radiology) Assistant Professor, Department of Radiology, Bilawal Medical College, Jamshoro, Pakistan.

出版信息

Pak J Med Sci. 2024 Jan-Feb;40(1Part-I):165-169. doi: 10.12669/pjms.40.1.7440.

Abstract

OBJECTIVE

To perform ultrasound examination in un-resolving frozen shoulder disorder, in Pakistani cohort visiting rheumatology clinic.

METHODS

This cross sectional study was carried out at Department of Rheumatology, Indus Medical College Tando Mohhamad Khan, from 16 March 2022 to 30 October 2022. Patients diagnosed as unilateral frozen shoulder on clinical grounds and received intra-articular injection (s) in last six months, never been investigated, still persisting with pain and restricted range of shoulder motion were enrolled. After the demographic details and shoulder examination, ultrasound examination of both shoulder joints was performed by senior musculoskeletal radiologist, to know the exact diagnosis.

RESULTS

In 138 cases on ultrasound examination following injuries were noted: rotator cuff tendinopathy (RCT) (61%), adhesive capsulitis (21%), mixed lesion (rotator cuff tendinopathy and adhesive capsulitis) (14%).In age group < 50 years rotator cuff tendinopathy was the major lesion, while in cases >50 years age group: adhesive capsulitis (AC) was predominant lesion (p-0.05).Rotator cuff tendinopathy had significant association with supraspinatus tears (p<0.5).

CONCLUSION

In Un-resolving frozen shoulder pain, ultrasound examination of involved joint helps in reaching the exact cause which may differ from the existing diagnosis and guides to further management.

摘要

目的

对前来风湿科门诊就诊的巴基斯坦人群中未缓解的肩周炎患者进行超声检查。

方法

本横断面研究于2022年3月16日至2022年10月30日在坦多穆罕默德汗印度医学院风湿科进行。纳入临床诊断为单侧肩周炎且在过去六个月内接受过关节内注射、从未接受过检查、仍有疼痛且肩部活动范围受限的患者。在记录人口统计学细节和进行肩部检查后,由资深肌肉骨骼放射科医生对双侧肩关节进行超声检查,以明确确切诊断。

结果

在138例患者的超声检查中发现以下损伤:肩袖肌腱病(RCT)(61%)、粘连性关节囊炎(21%)、混合性病变(肩袖肌腱病和粘连性关节囊炎)(14%)。在年龄小于50岁的组中,肩袖肌腱病是主要病变,而在年龄大于50岁的组中:粘连性关节囊炎(AC)是主要病变(p = 0.05)。肩袖肌腱病与冈上肌撕裂有显著相关性(p<0.5)。

结论

对于未缓解的肩周炎疼痛,对受累关节进行超声检查有助于明确确切病因,其可能与现有诊断不同,并为进一步治疗提供指导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66ac/10772408/0c0b9c00178b/PJMS-40-165-g001.jpg

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