Clinical and radiographic evaluation of the shoulder of spinal cord injured patients undergoing rehabilitation program

Abstract

Study design: Clinical and radiographic evaluation of the shoulders of tetraplegic and paraplegic patients who attend rehabilitation program. Objectives: The objective of this study is to establish the usefulness of radiography as a trial exam for shoulder pain in spinal cord injured patients. Setting: Hospital das ClinicasFUNICAMP. Campinas, Sao Paulo, Brazil. Methods: Thirty-two shoulders of 16 patients were evaluated by clinical exam and radiography. Patients were divided into two groups: paraplegic and tetraplegic. A control group of 16 normal volunteer subjects was selected. Results: Shoulder pain was reported in 88.89% of tetraplegic and 42.85% of paraplegic. The time of injury ranged from 1.5-22 years (mean 7.88 years); patients had a mean age of 34.68 years (range, 21-57 years). The acromioclavicular joint (ACJ) space ranged from 0.03-0.7 cm on the right side and 0.15-0.7 cm on the left side, with a mean of 0.37 and 0.41 cm, respectively. No correlation was found between shoulder pain and gender, age or time since injury. There was a trend to correlation between shoulder pain and type of injury with tetraplegic having a tendency to pain symptoms. On average, tetraplegic had smaller ACJ. Conclusions: The small number of patients in this study did not allow us to confirm the hypothesis that X-ray finding may indicate risk for shoulder pain in spinal cord injury patients. A work with a greater number of subjects could demonstrate association between shoulder pain and the reduced acromioclavicular distance, making plain radiography a trial exam for spinal cord-injured patients.

Risk factors for shoulder pain in patients with spinal cord injury: a multicenter study

“…Results of correlation between level of SCI and shoulder pain are similar to published data [10,11,[14][15][16]. Furthermore, in our study, high thoracic SCI (T2-T7) patients have more chances of presenting shoulder pain.…”

Trajectories of musculoskeletal shoulder pain after spinal cord injury: Identification and predictors

“…This is lower than prevalence of shoulder pain in the literature on persons with chronic SCI, which is found to be between 60 and 89%. 2,4,12,14,15 Unfortunately, these studies mostly do have a cross-sectional study design, use a different definition of shoulder pain (distinguish musculoskeletal and neuropathic pain), and use different outcome measures and/or include different populations and TSI. Therefore, comparison with prevalence of shoulder pain in our study should be interpreted with caution.…”

Prevalence of Shoulder Pain in Spinal Cord Injury Patients Referring to the Brain and Spinal Cord Injury Research Center of Tehran University of Medical Sciences

“…Age, gender, injury level, injury duration and the number of times moving from wheelchair onto bed and back factors which reported in previous research affect shoulder pain (23)(24)(25). Studies also indicated that the time passed after the injury and transferring from wheelchair to bed and back were considered as influential factors on shoulder pain (11,26).…”