Doo-Hyung Lee1, Ji Yeon Hong2, Michael Young Lee3, Kyu-Sung Kwack4, Seung-Hyun Yoon5. 1. Department of Orthopedic Surgery, Ajou University School of Medicine, Suwon, Republic of Korea. 2. Department of Physical Medicine and Rehabilitation, Ajou University School of Medicine, Suwon, Republic of Korea. 3. Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC. 4. Department of Radiology, Ajou University School of Medicine, Suwon, Republic of Korea. 5. Department of Physical Medicine and Rehabilitation, Ajou University School of Medicine, Suwon, Republic of Korea. Electronic address: yoonsh@ajou.ac.kr.
Abstract
OBJECTIVE: To evaluate the correlations between subacromial bursitis (bursal thickening and effusion) on ultrasonography and its response to subacromial corticosteroid injection in patients with rotator cuff disease. DESIGN: Prospective, longitudinal comparison study. SETTING: University-affiliated tertiary care hospital. PARTICIPANTS: Patients with rotator cuff disease (N=69) were classified into 3 groups based on ultrasonographic findings; (1) normative bursa group (group 1, n=23): bursa and effusion thickness <1mm; (2) bursa thickening group (group 2, n=22): bursa thickness >2mm and effusion thickness <1mm; and (3) bursa effusion group (group 3, n=24): bursa thickness <1mm and effusion thickness >2mm. INTERVENTION: A single subacromial injection with 20mg of triamcinolone acetonide. MAIN OUTCOME MEASURES: Visual analog scale (VAS) of shoulder pain, Shoulder Disability Questionnaire (SDQ), angles of active shoulder range of motion (flexion, abduction, external rotation, and internal rotation), and bursa and effusion thickness at pre- and posttreatment at week 8. RESULTS: There were no significant differences between the 3 groups in demographic characteristics pretreatment. Groups 2 and 3 showed a significant difference compared with group 1 in changes on the VAS and abduction; group 3 showed a significant difference compared with group 1 in changes of the SDQ, internal rotation, and external rotation; and all groups showed significant differences when compared with each other (groups 1 and 3, 2 and 3, and 1 and 2) in changes of thickness. CONCLUSIONS: A patient with ultrasonographic observation of subacromial bursitis, instead of normative bursa, can expect better outcome with subacromial corticosteroid injection. Therefore, we recommend a careful selection of patients using ultrasonography prior to injection.
OBJECTIVE: To evaluate the correlations between subacromial bursitis (bursal thickening and effusion) on ultrasonography and its response to subacromial corticosteroid injection in patients with rotator cuff disease. DESIGN: Prospective, longitudinal comparison study. SETTING: University-affiliated tertiary care hospital. PARTICIPANTS: Patients with rotator cuff disease (N=69) were classified into 3 groups based on ultrasonographic findings; (1) normative bursa group (group 1, n=23): bursa and effusion thickness <1mm; (2) bursa thickening group (group 2, n=22): bursa thickness >2mm and effusion thickness <1mm; and (3) bursa effusion group (group 3, n=24): bursa thickness <1mm and effusion thickness >2mm. INTERVENTION: A single subacromial injection with 20mg of triamcinolone acetonide. MAIN OUTCOME MEASURES: Visual analog scale (VAS) of shoulder pain, Shoulder Disability Questionnaire (SDQ), angles of active shoulder range of motion (flexion, abduction, external rotation, and internal rotation), and bursa and effusion thickness at pre- and posttreatment at week 8. RESULTS: There were no significant differences between the 3 groups in demographic characteristics pretreatment. Groups 2 and 3 showed a significant difference compared with group 1 in changes on the VAS and abduction; group 3 showed a significant difference compared with group 1 in changes of the SDQ, internal rotation, and external rotation; and all groups showed significant differences when compared with each other (groups 1 and 3, 2 and 3, and 1 and 2) in changes of thickness. CONCLUSIONS: A patient with ultrasonographic observation of subacromial bursitis, instead of normative bursa, can expect better outcome with subacromial corticosteroid injection. Therefore, we recommend a careful selection of patients using ultrasonography prior to injection.
Authors: Li Jiang; Juanjuan He; Carl P C Chen; Dongfeng Xie; Yiying Mai; Boyu Yue; Zulin Dou Journal: Biomed Res Int Date: 2020-08-25 Impact factor: 3.411