Objective To explore ultrasonographic characteristics of hemiplegic shoulders and investigate the cause of shoulder pain with high-resolution ultrasound.Methods A total of 93 patients who suffered from post-stroke hemiplegic shoulders for the first time underwent high frequency ultrasonography of shoulders. Subjects were assigned to shoulder pain group and without pain group. Variables were compared between patients with shoulder pain and those without. Modified Ashworth scores and Brunnstrom recovery stages were used to evaluate the muscle tone and motor function of the upper limb of patients.Results Seventy-five cases(80.7%)of abnormal ultrasound findings were found among the ninety-three stroke patients. The findings of ultrasound disclosed 25 cases of rotator cuff injury, 31 cases of bursitis and bursa effusion, 28 cases of shoulder subluxation and 50 cases of lesions of the long head of biceps tendon. There was significant difference in the incidence of the diseases mentioned above between the two groups (χ2=8.67,P<0.01; χ2=6.99,P<0.01; χ2=13.44,P<0.01; χ2=3.87,P<0.05). There was, however, no significant difference in the age, gender, side of hemiplegia, type and duration, upper limb muscle tone and motor function between these two groups.Conclusions High frequency ultrasound is a good means to test shoulder pain in patients with post-stroke hemiplegia. Sonographic findings provide data for the diagnosis and recovery of patients with hemiplegic shoulder pain.
Key words
stroke /
hemiplegia /
shoulder pain /
ultrasound diagnosis
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References
[1] Aras M D, Gokkaya N K, Comert D, et al. Shoulder pain in hemiplegia: results from a national rehabilitation hospital in Turkey [J]. Am J Phys Med Rehabil,2004,83(9): 713-719.
[2] 王金锐,刘吉斌. 肌肉骨骼系统超声影像学[M].北京:科学技术文献出版社,2007: 21-45.
[3] Naghdi S, Ansari N N, Mansouri K, et al. A neurophysiological and clinical study of Brunnstrom recovery stages in the upper limb following stroke[J].Brain In J, 2010,24(11): 1372-1378.
[4] 吴赤球,李春玲,高永艳,等. 高频超声评价运动训练对肱二头肌长头腱形态学的影响[J].中国医学影像学杂志,2014, 22(8):617-619,623.
[5] Coskun Benlidayi I, Basaran S. Hemiplegic shoulder pain: a common clinical consequence of stroke [J]. Pract Neurol, 2014, 14(2):88-91.
[6] Pong Y P, Wang L Y, Wang L, et al. Sonography of the shoulder in hemiplegic patients undergoing rehabilitation after a recent stroke [J]. J Clin Ultrasound, 2009, 37(4): 199.
[7] Pong Y P, Wang L Y, Huang Y C, et al. Sonography and physical findings in stroke patients with hemiplegic shoulders: a longitudinal study [J]. J Rehabil Med, 2012, 44(7): 553-557.
[8] Lee I S, Shin Y B, Moon T Y, et al.Sonography of patients with hemiplegic shoulder pain after stroke: correlation with motor recovery stage [J]. Am J Roentgenol, 2009,192(2): 40-44.
[9] Kim Y H, Jung S J, Yang E J, et al. Clinical and sonographic risk factors for hemiplegic shoulder pain: a longitudinal observational study [J].J Rehabil Med,2014,46(1):81-87.
[10] Park G Y, Kim J M, Sohn S I, et al. Ultrasonographic measurement of shoulder subluxation in patients with post-stroke hemiplegia [J]. J Rehabil Med, 2007, 39(7): 526-530.
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