M F García Díaz1, M Medina Sánchez. 1. Licenciada en Medicina y Cirugía, Especialista en Medicina Familiar y Comunitaria, Real Grupo de Cultura Covadonga, Gijón, Asturias, España. garciadiaz@telecable.es
Abstract
OBJECTIVES: To describe the population attending teaching health centres in Area V, Asturias, to consult for painful shoulder. To describe the examination, diagnosis, treatment and clinical response. DESIGN: Longitudinal, descriptive study. SETTING: Teaching health centres in Area V, Asturias. PARTICIPANTS: Patients consulting because of pain in their shoulders in October and November 2002. MAIN MEASUREMENTS: Two measurements, the first of which in December 2002 appraised age, sex, job, time off work, arc of pain, flection, internal-external rotation, and diagnostic impression. The second, in May 2003, assessed evolution, x-rays, echography, medication, infiltration, physiotherapy, exercises at home, referral to specialist, and final diagnosis. Bivariant and kappa index descriptive analyses were run. RESULTS: 110 cases, 58.2% women and 41.8% men, with an average age of 57 (95% CI, 54.17-59.79), were included. 52.7% were retired; no particular job predominated; 7.3% were off work; 30% had had no examination of arc of movement; 70% evolved satisfactorily. The most common diagnosis was cuff tendinitis, with initial and final diagnosis coinciding well. 77.4% of patients took NSAIDs; 16% were infiltrated; 32.1% did physiotherapy; and 36.8%, exercises at home. 65.1% had no x-ray and only 6.6% had echographies, all of which found something. There was no statistically significant relationship between medication or infiltration and favourable evolution; and there was, between physiotherapy or exercises and favourable evolution. CONCLUSIONS: Most patients were middle-aged, women, pensioners, and had little time off work. Two-thirds evolved well. Examinations were incomplete and few complementary tests were run.
OBJECTIVES: To describe the population attending teaching health centres in Area V, Asturias, to consult for painful shoulder. To describe the examination, diagnosis, treatment and clinical response. DESIGN: Longitudinal, descriptive study. SETTING: Teaching health centres in Area V, Asturias. PARTICIPANTS: Patients consulting because of pain in their shoulders in October and November 2002. MAIN MEASUREMENTS: Two measurements, the first of which in December 2002 appraised age, sex, job, time off work, arc of pain, flection, internal-external rotation, and diagnostic impression. The second, in May 2003, assessed evolution, x-rays, echography, medication, infiltration, physiotherapy, exercises at home, referral to specialist, and final diagnosis. Bivariant and kappa index descriptive analyses were run. RESULTS: 110 cases, 58.2% women and 41.8% men, with an average age of 57 (95% CI, 54.17-59.79), were included. 52.7% were retired; no particular job predominated; 7.3% were off work; 30% had had no examination of arc of movement; 70% evolved satisfactorily. The most common diagnosis was cuff tendinitis, with initial and final diagnosis coinciding well. 77.4% of patients took NSAIDs; 16% were infiltrated; 32.1% did physiotherapy; and 36.8%, exercises at home. 65.1% had no x-ray and only 6.6% had echographies, all of which found something. There was no statistically significant relationship between medication or infiltration and favourable evolution; and there was, between physiotherapy or exercises and favourable evolution. CONCLUSIONS: Most patients were middle-aged, women, pensioners, and had little time off work. Two-thirds evolved well. Examinations were incomplete and few complementary tests were run.
Authors: Simon Carette; Hélène Moffet; Johanne Tardif; Louis Bessette; Frédéric Morin; Pierre Frémont; Vivian Bykerk; Carter Thorne; Mary Bell; William Bensen; Caty Blanchette Journal: Arthritis Rheum Date: 2003-03