Ultrasonographic findings of shoulders in individuals with spinal cord injury

The Journal of Spinal Cord Medicine, 2021 · DOI: 10.1080/10790268.2019.1673547 · Published: January 1, 2021

Spinal Cord Injury Medical Imaging Orthopedics

Simple Explanation

Spinal cord injuries can lead to motor and sensory deficits, causing patients to rely heavily on their upper limbs for mobility and daily activities. This overuse can put repetitive stress on the shoulder structures, potentially leading to shoulder pain. Shoulder pain is a common issue for individuals with spinal cord injuries, particularly those who use wheelchairs. This pain can negatively impact their rehabilitation and daily activities, potentially leading to a less active lifestyle. Ultrasonography is more sensitive than clinical tests for diagnosing shoulder pain and identifying its causes. It's a noninvasive, radiation-free method that allows for direct assessment of shoulder movement and anatomy.

Study Duration

Not specified

Participants

91 SCI patients (56 with paraplegia and 35 with quadriplegia)

Evidence Level

Cross-sectional descriptive study

Key Findings

1
The most common ultrasonographic abnormality found in SCI patients was unilateral subdeltoid-subacromion bursitis.
2
Patients with quadriplegia showed unilateral subdeltoid-subacromion bursitis (65.7%), unilateral supraspinatus tendinosis (45.7%), and unilateral biceps tendon effusion (37.2%).
3
Patients with paraplegia presented unilateral subdeltoid-subacromion bursitis (64.3%), unilateral biceps tendon effusion (55.4%), and unilateral supraspinatus tendinosis (53.6%).

Research Summary

This study investigated shoulder ultrasonography findings in individuals with spinal cord injury (SCI) to identify factors associated with ultrasonographic abnormalities. Ninety-one SCI patients were enrolled, including those with paraplegia and quadriplegia. The most common ultrasonographic abnormality in both quadriplegic and paraplegic patients was unilateral subdeltoid-subacromion bursitis. Other common abnormalities included supraspinatus tendinosis and biceps tendon effusion. The study highlights the prevalence of abnormal shoulder ultrasound findings in individuals with SCI, suggesting that physicians should be aware of potential abnormalities involving various shoulder structures when assessing shoulder pain in these patients.

Practical Implications

Diagnostic Awareness

Physicians should consider ultrasonography for evaluating shoulder pain in SCI patients, being aware of the high prevalence of subdeltoid-subacromion bursitis.

Treatment Planning

Accurate diagnosis of shoulder pain causes can lead to corrected treatment plans and improved outcomes for SCI patients.

Further Research

Future prospective longitudinal studies are needed to examine ultrasonographic changes in the shoulders of SCI patients over time.

Study Limitations

1
The study assessed participants at only one time point, lacking surgical confirmation or clinical follow-up results.
2
The study could not determine the long-term prognosis of shoulder abnormalities or their symptomatic progression.
3
The sample size may have limited the ability to detect statistically significant associations between factors and ultrasonographic findings.

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