견관절 통증을 동반한 편마비 환자의 자기 공명 관절 조영술 소견
Magnetic Resonance Arthrographic Findings of the Painful Hemiplegic Shoulder
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Objective: To identify the etiology of hemiplegic shoulder pain by magnetic resonance (MR) arthrography.Method: The study included seventy-four hemiplegic patients with shoulder pain. After several physical examinations, all patients had fluoroscopically guided injection by a physiatrist with a maximum of 12∼15 ml of contrast agent. Then T1-weighted, T2-weighted and fat-suppressed T1-weighted images were taken at the oblique coronal plane. In addition, fat-suppressed T1-weighted images were obtained at the oblique sagittal and oblique coronal plane. Results: Except for the 9 patients who did not finish the study, the mean age of the participants was 61.5±8.9 years and mean duration of the cerebrovascular accident (CVA) was 15.7±9.7 weeks. The findings were as follows: 40% supraspinatus tendinitis, 30.8% superior labrum anterior to posterior (SLAP) lesion, 29.2% adhesive capsulitis, 24.6% supraspinatus partial tear, 23.1% biceps tendinitis, 13.8% supraspinatus full thickness tear, 7.7% infraspinatus partial tear. The SLAP lesion had significant statistic relationship with biceps tendinitis (p＜0.05) but not with rotator cuff lesion. Conclusion: We found that causes of hemiplegic shoulder pain were various. The prevalence of the SLAP lesion was high (30.8%). We recommend the MR arthrography when the hemiplegic shoulder pain does not improve by conventional therapy or the cause of the pain is uncertain.
Abstract
Objective: To identify the etiology of hemiplegic shoulder pain by magnetic resonance (MR) arthrography.Method: The study included seventy-four hemiplegic patients with shoulder pain. After several physical examinations, all patients had fluoroscopically guided injection by a physiatrist with a maximum of 12∼15 ml of contrast agent. Then T1-weighted, T2-weighted and fat-suppressed T1-weighted images were taken at the oblique coronal plane. In addition, fat-suppressed T1-weighted images were obtained at the oblique sagittal and oblique coronal plane. Results: Except for the 9 patients who did not finish the study, the mean age of the participants was 61.5±8.9 years and mean duration of the cerebrovascular accident (CVA) was 15.7±9.7 weeks. The findings were as follows: 40% supraspinatus tendinitis, 30.8% superior labrum anterior to posterior (SLAP) lesion, 29.2% adhesive capsulitis, 24.6% supraspinatus partial tear, 23.1% biceps tendinitis, 13.8% supraspinatus full thickness tear, 7.7% infraspinatus partial tear. The SLAP lesion had significant statistic relationship with biceps tendinitis (p＜0.05) but not with rotator cuff lesion. Conclusion: We found that causes of hemiplegic shoulder pain were various. The prevalence of the SLAP lesion was high (30.8%). We recommend the MR arthrography when the hemiplegic shoulder pain does not improve by conventional therapy or the cause of the pain is uncertain.
참고문헌 (25)
- Bender L, "Hemiplegic shoulder pain: defining the problem and its management", Disabil Rehabil, 23, pp.698~705 (2001)
- Turner-Stokes L, "Shoulder pain after stroke: a review of the evidence base to inform the development of an integrated care pathway", Clin Rehabil, 16, pp.276~298 (2002)
- Fotias F, "Hemiplegic shoulder syndrome: possible underlying neurophysiological mechanisms", Phys Ther Rev, 10, pp.51~58 (2005)
- Ko MH, "Comparison of ultrasonographic findings with clinical findings in hemiplegic shoulder", J Korean Acad Rehab Med, 30, pp.213~218 (2006)
- Tallroth K, "Shoulder imaging: a review", Ann Chir gynaecol, 85, pp.95~103 (1996)
- Farin PU, "Sonographic findings of rotator cuff calcifications", J Ultrasound Med, 14, pp.7~14 (1995)
- Rutten Matthieu FCM, "US of the rotator cuff: pitfalls, limitations, and artifacts", Radiographics, 26, pp.589~604 (2006)
- Naredo E, "Painful shoulder: comparison of physical examination and ultrasonographic findings", Ann Rheum Dis, 61, pp.132~136 (2002)
- Steinbach LS, "Special focus session: MR arthrography", Radiographics, 22, pp.1223~1246 (2002)
- Brenner ML, "Direct MR arthrography of the shoulder: is exercise prior to imaging beneficial or detrimental?", Radiology, 215, pp.491~496 (2000)
- Waldt S, "Diagnostic performance of MR arthrography in the assessment of superior labral anteroposterior lesions of the shoulder", AJR, 182, pp.1271~1278 (2004)
- Terry GC, "Functional anatomy of the shoulder", J Athl Train, 35, pp.248~255 (2000)
- Farmer KD, "MR arthrography of the shoulder: fluoroscopically guided technique using a posterior approach", AJR, 178, pp.433~434 (2002)
- Mengiardi B, "Frozen shoulder: MR arthrographic findings", Radiology, 233, pp.486~492 (2004)
- Patton WC, "Biceps tendinitis and subluxation", Clin Sports Med, 20(3) (2001)
- Mohana-Borges Aurea VR, "Superior labral anteroposterior tear: classification and diagnosis on MRI and MR arthrography", AJR, 181, pp.1449~1462 (2003)
- Resnick D, "Internal derangement of joints, 2nd ed", pp.827~834 (2007), WB Saunders Company
- Shin JB, "Causes of the painful hemiplegic shoulder and comparison of the results of radiologic evaluation", J Korean Acad Rehab Med, 27, pp.293~299 (2003)
- Gartsman GM, "Partial thickness rotator cuff tears: Evaluation and treatment", Current Orthopaedics, 14, pp.167~172 (2000)
- Nepomuceno CS, "Shoulder arthrography in hemiplegic patients", Arch Phys Med Rehabil, 55, pp.49~51 (1974)
- Najenson T, "Rotator cuff injury in shoulder joints of hemiplegic patients", Scand J Rehabil Med, 3, pp.131~137 (1971)
- Ouwenaller CV, "Painful shoulder in hemiplegia", Arch Phys Med Rehabil, 6, pp.23~36 (1986)
- Kim JH, "Frequency and pattern of partial thickness rotator cuff tear in SLAP lesions", J Korean Arthroscopy Soc, 8, pp.119~123 (2004)
- Hakuno A, "Arthrographic finding in hemiplegic shoulders", Arch Phys Med Rehabil, 65, pp.706~711 (1984)
- Rowan KR, "MR shoulder arthrography in patients younger than 40 years of age: frequency of rotator cuff tear versus labroligamentous pathology", Australas Radiol, 51, pp.257~259 (2007)