Contrast-enhanced MRI of the subdeltoid, subacromial bursa in painful and painless rotator cuff tears

Hodgson, Richard; O’Connor, Philip; Hensor, Elizabeth M A; Barron, Dominic A; Robinson, Philip

doi:10.1259/bjr/45423226

Cited by 15 publications

(15 citation statements)

References 41 publications

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“…In total, 56 articles were included (41 cross‐sectional, 11 cohort, 4 case–control). Imaging modalities included 25 ultrasound 16, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 24 MRI 15, 16, 41, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 12 radiographs 27, 30, 49, 53, 55, 62, 65, 66, 67, 68, 69, 70, 3 bone scintigraphy 65, 71, 72, 2 PET 73, 74, and no computed tomography. Of these studies, 10 assessed associations with 2 imaging modalities (16, 27, 30, 41, …”

Section: Resultsmentioning

confidence: 99%

“…The mean (range) score was 48% 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67 for cohort, 41% 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41...…”

Section: Resultsmentioning

confidence: 99%

“…Ten studies (16, 21, 24, 25, 31, 49, 51, 53, 54, 61) evaluated the relationship between the subacromial bursa (SAB) and symptoms (Tables 1, 2, and 3). Five mixed‐quality ultrasound studies 16, 21, 24, 25, 31 and 2 MRI studies of mixed quality 16, 61 reported an association between SAB and pain.…”

Section: Resultsmentioning

confidence: 99%

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What Imaging‐Detected Pathologies Are Associated With Shoulder Symptoms and Their Persistence? A Systematic Literature Review

Tran

Cowling

Smith

et al. 2018

Arthritis Care & Research

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ObjectiveShoulder symptoms are common, and imaging is being increasingly used to help with management. However, the relationship between imaging and symptoms remains unclear. This review aims to understand the relationship between imaging‐detected pathologies, symptoms, and their persistence.MethodsA systematic review using Medline, EMBASE, Cochrane, and grey literature was conducted to April 2017. The cross‐sectional and longitudinal relationships between imaging‐detected abnormalities and symptoms were analyzed and associations qualitatively characterized by a best‐evidence synthesis based on study design, covariate adjustment, and the Grade of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. Modalities included ultrasound, magnetic resonance imaging (MRI), radiographs, positron emission tomography (PET), bone scintigraphy, and computed tomography.ResultsA total of 6,569 abstracts was screened and 56 articles were included. In total, 50 studies did not adjust for covariates and 36 analyzed individual pathologies only. The majority of studies showed conflicting results. There was no significant association between most imaging features and symptoms among high‐quality, cross‐sectional studies. There was low‐quality evidence that enhancement of the joint capsule on MRI and increased uptake on PET were associated with symptoms in adhesive capsulitis. Based on high‐quality longitudinal studies, enlarging rotator cuff tears were associated with an increased incidence of symptoms.ConclusionThere were conflicting results on the association of imaging features with shoulder symptoms and their persistence. The existing evidence was very low in quality, based on the GRADE methodology. Further high‐quality studies are required to understand the relationship between imaging and shoulder symptoms and to determine the appropriate role of imaging in care pathways.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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What Imaging‐Detected Pathologies Are Associated With Shoulder Symptoms and Their Persistence? A Systematic Literature Review

Tran

Cowling

Smith

et al. 2018

Arthritis Care & Research

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“…According to the literature, patients with only supraspinatus calcific tendinopathy were symptomatic in 6 % of the cases [8][9][10]. Patients with supraspinatus calcific tendinopathy and pain had bursitis [Fig.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of subacromial-subdeltoid bursitis in shoulder pain: an ultrasonographic study

et al. 2015

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Purpose The presence of the subacromial-subdeltoid (SASD) bursa inflammation has recently been proposed as a primary radiologic factor predicting persistent limitation and pain in operated patients. The aim of the study was to verify the hypothesis that pain, or increased shoulder pain, could be associated with SASD bursitis not only in operated patients but also in general population. Methods A consecutive series of 1940 shoulder ultrasound examinations were performed by our Department over a 5-year period using linear multi-frequency probes. All reports of examination executed for shoulder pain were reviewed. The video clips were independently reviewed by two radiologists: effusion in the SASD bursa and the presence of other pathological conditions were evaluated and confirmed. Results A total of 1147 shoulder video clips were reevaluated, and 1587 pathologies were detected; 65.5 % of patients had only one pathology, 30.4 % had two and 4.1 % presented three pathologies. The difference between the group with and without effusion is statistically significant for acromioclavicular joint arthritis, supraspinatus tendon calcific tendinopathy, full-thickness and superficial tear of the supraspinatus, traumas and rheumatoid arthritis with a p value \0.01. Conclusions Our study shows that the effusion in the SASD bursa is frequently associated with shoulder pain often independently from the underlying pathology; further studies are needed to confirm the statistical significance of this relationship by clarifying possible confounding factors.Keywords Ultrasound Á Subacromion-subdeltoid bursa Á Bursal inflammation Á Shoulder pain Riassunto Scopo del lavoro La presenza di alterazioni flogistiche a livello della borsa subacromiondeltoidea (BSAD) è stata recentemente proposta come fattore principale per predire la comparsa di dolore e limitazione funzionale nei Pazienti operati a livello della spalla. Lo scopo del nostro studio è di verificare l'ipotesi che il dolore, o l'incremento dello stesso, sia associato con la flogosi della BSAD non solo nei Pazienti operati ma anche nella popolazione generale. Materiali e Metodi In 5 anni nel nostro dipartimento sono state eseguite, utilizzando esclusivamente sonde lineari multifrequenza, 1940 ecografie della spalla. Tutti gli esami aventi come indicazione il dolore sono stati selezionati. I videoclip degli esami selezionati sono stati rivalutati da due radiologi indipendentemente: è stata in tal modo confermata la presenza di versamento nella BSAD e di altri reperti patologici. Risultati Sono stati rivalutati i videoclip di 1147 ecografie di spalla. Sono state individuate 1587 alterazioni patologiche; il 65.5 % dei Pazienti presentava unicamente un riscontro patologico, il 30.4 % ne presentava due e il 4.1 % ne presentava 3. La differenza tra gruppo con e senza versamento è statisticamente significativa (p value \0.01) in caso di artrosi acromionclaveare, tendinopatia calcifica del sovraspinato, lesioni a tutto spessore e del versante bursale del tendine del sovraspinato, ...

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“…Particularly in areas of the shoulder joint where the muscles or tendons and bones cross each other, bursae between them play important roles in maintenance of joint function [2]. Many previous studies have clarified both anatomically and clinically that the subacromial bursa helps the greater tuberosity of the humerus to smoothly glide under the coracoacromial arch [2][3][4][5][6]. However, only a few studies have investigated the subscapular bursa [7,8] and the clinical importance of this bursa remains incompletely understood [9,10].…”

Section: Introductionmentioning

confidence: 99%

Involvement of the Subscapular Bursa as a Cause of Throwing Pain

Inui¹

2015

JESO

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Open Access Research Articlethe bursae play an important role in the suppression of friction associated with those movements. We hypothesized that friction of the subscapularis tendon coiling along the coracoid process often causes pain during throwing motion and investigated in which position pain would occur in a clinical scenario. MethodsThis study involved 110 baseball players who visited our hospital for consultation regarding their symptoms and who were followed up for at least 6 months. All were men with an average age of 27 years (range, 16-36 years). The dominant arm was affected in all players. The subjects comprised 52 high schooling, 11 collegiate, 9 professional, and 38 recreational level players. Their baseball playing positions were 50 pitchers, 9 catchers, 19 infielders, and 32 outfielders. Clinical featuresAll players complained of shoulder pain during throwing, especially in the acceleration phase, and stated that their performance level was decreased owing to throwing pain. The passive glenohumeral range of motion was assessed using a large goniometer. Angles of internal and external rotations in the coronal plane at 90° of abduction were measured in bilateral sides. Measurements were recorded with each subject lying supine to stabilize the scapula. The dominant extremity showed more external rotation at 90° of abduction and less internal rotation at 90° of abduction than did the contralateral extremity. The mean external rotation and internal rotation with the dominant extremity were 105° ± 13° and 50° ± 12°, respectively, and those with the contralateral extremity were 101° ± 14° and 59° ± 11°, respectively. Distension arthrographyTen milliliters of dye compounded with 10 ml of local anesthetic was injected into the joint. In 29 patients (26%), leakage or pooling of the dye in the supraspinatus or infraspinatus tendons occurred (Figure 1). After evaluation, the shoulder was forced to internally rotate to distend the dye to the subscapularis bursa. This direction of dye distension was confirmed with plain radiographs after arthrography (Figure 2). In 14 patients, the dye also leaked from the bicipital groove. AbstractLittle attention has been paid to a role of the subscapular bursa keeping smooth movement of the shoulder. We hypothesized that irritation in the subscapular bursa causes throwing pain and investigated in which position pain would occur in a clinical scenario and effectiveness of distension arthrography for pain relief in baseball players. One hundred and ten baseball players with shoulder pain were enrolled in this study. All underwent examination of whether pain was provoked with arm rotation at different angles of abduction before and after arthrography. Factors including skill level, playing position, symptom duration, and concurrent injury of the rotator cuff tendon were investigated to affect the results. All patients experienced pain with external rotation at 135° of abduction before arthrography, and the pain was reduced after arthrography in 92 players (84%). Thirty-thre...

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Contrast-enhanced MRI of the subdeltoid, subacromial bursa in painful and painless rotator cuff tears

Cited by 15 publications

References 41 publications

What Imaging‐Detected Pathologies Are Associated With Shoulder Symptoms and Their Persistence? A Systematic Literature Review

What Imaging‐Detected Pathologies Are Associated With Shoulder Symptoms and Their Persistence? A Systematic Literature Review

Prevalence of subacromial-subdeltoid bursitis in shoulder pain: an ultrasonographic study

Involvement of the Subscapular Bursa as a Cause of Throwing Pain

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