医学
渗出
肩袖
曲安奈德
运动范围
滑囊炎
肩峰下囊
醋酸甲基强的松龙
可视模拟标度
外科
皮质类固醇
前瞻性队列研究
肩撞击综合征
物理疗法
作者
Doo‐Hyung Lee,Ji Yeon Hong,Michael Young Lee,Kyu-Sung Kwack,Yoon Sh
标识
DOI:10.1016/j.apmr.2016.11.025
摘要
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.
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