Impact of outpatient clinic ultrasound imaging in the diagnosis and treatment for shoulder impingement: a randomized prospective study.

Hdl Handle:
http://hdl.handle.net/10147/305277
Title:
Impact of outpatient clinic ultrasound imaging in the diagnosis and treatment for shoulder impingement: a randomized prospective study.
Authors:
Saeed, Aamir; Khan, Mumtaz; Morrissey, Siobhan; Kane, David; Fraser, Alexander Duncan
Affiliation:
Department of Rheumatology, Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland, modelian@gmail.com.
Citation:
Impact of outpatient clinic ultrasound imaging in the diagnosis and treatment for shoulder impingement: a randomized prospective study. 2013: Rheumatol. Int.
Journal:
Rheumatology international
Issue Date:
5-Nov-2013
URI:
http://hdl.handle.net/10147/305277
DOI:
10.1007/s00296-013-2892-z
PubMed ID:
24190232
Abstract:
The use of musculoskeletal ultrasonography (MSUS) in guiding subdeltoid injection has been shown to improve outcome up to 6 weeks in a few small studies. A recent meta-analysis identified the need for further studies with longer-term outcome and larger sample size. This randomized prospective study assessed whether clinic-based MSUS can significantly improve diagnostic accuracy in shoulder pain and whether MSUS-guided shoulder injection results in improved long-term outcomes. One hundred consecutive patients with 125 painful shoulders were recruited. Patients were randomized to receive either sonographic assessment with consequent palpation-guided injection (Group 1, n = 66) or sonographic assessment with a MSUS-guided injection of 40 mg of methylprednisolone acetate (Group 2, n = 59). A blinded rheumatologist (ADF) performed clinical assessments at baseline, 6 and 12 weeks including shoulder function tests (SFTs) (Hawkins-Kennedy test, supraspinatus tendon tenderness), physician global assessment (PGA) and patient visual analogue scores (VAS) for pain (0-10). Eighty patients with 90 symptomatic shoulders completed 12-week follow-up. Twenty patients, 11 (20 shoulders) from the palpation-guided group and 9 (15 shoulders) from the MSUS-guided group, were excluded at 6 weeks either due to requirement for repeat injection or due to surgical referral. Mean age for patients was 57.7 years, and 65 % patients were female; mean shoulder pain duration was 18 weeks (range 14-22 weeks). SFTs, patient VAS and PGA scores for pain improved significantly from baseline in both groups with significantly greater improvements in the MSUS-guided group (44 shoulders) compared to the palpation-guided group (46 shoulders) in all parameters at 6 (p < 0.01) and 12 weeks (p < 0.05). The use of MSUS in guiding subdeltoid injection has been shown to improve outcome up to 6 weeks in a few small studies. A recent meta-analysis identified the need for further studies with longer-term outcome and larger sample size.
Item Type:
Article
Language:
en
Keywords:
RHEUMATIC DISORDER
ISSN:
1437-160X

Full metadata record

DC FieldValue Language
dc.contributor.authorSaeed, Aamiren_GB
dc.contributor.authorKhan, Mumtazen_GB
dc.contributor.authorMorrissey, Siobhanen_GB
dc.contributor.authorKane, Daviden_GB
dc.contributor.authorFraser, Alexander Duncanen_GB
dc.date.accessioned2013-11-12T16:50:15Z-
dc.date.available2013-11-12T16:50:15Z-
dc.date.issued2013-11-05-
dc.identifier.citationImpact of outpatient clinic ultrasound imaging in the diagnosis and treatment for shoulder impingement: a randomized prospective study. 2013: Rheumatol. Int.en_GB
dc.identifier.issn1437-160X-
dc.identifier.pmid24190232-
dc.identifier.doi10.1007/s00296-013-2892-z-
dc.identifier.urihttp://hdl.handle.net/10147/305277-
dc.description.abstractThe use of musculoskeletal ultrasonography (MSUS) in guiding subdeltoid injection has been shown to improve outcome up to 6 weeks in a few small studies. A recent meta-analysis identified the need for further studies with longer-term outcome and larger sample size. This randomized prospective study assessed whether clinic-based MSUS can significantly improve diagnostic accuracy in shoulder pain and whether MSUS-guided shoulder injection results in improved long-term outcomes. One hundred consecutive patients with 125 painful shoulders were recruited. Patients were randomized to receive either sonographic assessment with consequent palpation-guided injection (Group 1, n = 66) or sonographic assessment with a MSUS-guided injection of 40 mg of methylprednisolone acetate (Group 2, n = 59). A blinded rheumatologist (ADF) performed clinical assessments at baseline, 6 and 12 weeks including shoulder function tests (SFTs) (Hawkins-Kennedy test, supraspinatus tendon tenderness), physician global assessment (PGA) and patient visual analogue scores (VAS) for pain (0-10). Eighty patients with 90 symptomatic shoulders completed 12-week follow-up. Twenty patients, 11 (20 shoulders) from the palpation-guided group and 9 (15 shoulders) from the MSUS-guided group, were excluded at 6 weeks either due to requirement for repeat injection or due to surgical referral. Mean age for patients was 57.7 years, and 65 % patients were female; mean shoulder pain duration was 18 weeks (range 14-22 weeks). SFTs, patient VAS and PGA scores for pain improved significantly from baseline in both groups with significantly greater improvements in the MSUS-guided group (44 shoulders) compared to the palpation-guided group (46 shoulders) in all parameters at 6 (p < 0.01) and 12 weeks (p < 0.05). The use of MSUS in guiding subdeltoid injection has been shown to improve outcome up to 6 weeks in a few small studies. A recent meta-analysis identified the need for further studies with longer-term outcome and larger sample size.en_GB
dc.languageENG-
dc.language.isoenen
dc.rightsArchived with thanks to Rheumatology internationalen_GB
dc.subjectRHEUMATIC DISORDERen_GB
dc.titleImpact of outpatient clinic ultrasound imaging in the diagnosis and treatment for shoulder impingement: a randomized prospective study.en_GB
dc.typeArticleen
dc.contributor.departmentDepartment of Rheumatology, Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland, modelian@gmail.com.en_GB
dc.identifier.journalRheumatology internationalen_GB
dc.description.noteThe final publication is available at link.springer.com.-
dc.description.fundingNo fundingen
dc.description.provinceLeinsteren
dc.description.peer-reviewpeer-reviewen
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