BILATERALMAGNETIC RESONANCE IMAGING FINDINGS IN INDIVIDUALSWITH UNILATERAL SHOULDER PAIN
Magnetic resonance imaging (MRI) is commonly used to diagnose structural abnormalities in the shoulder. However, subsequent findings may not be the source of symptoms. The aim of this study was to determine comparative MRI findings across both shoulders of individuals with unilateral shoulder symptoms. Materials and methods We prospectively evaluated 123 individuals from the community who had self-reported unilateral shoulder pain with no signs of adhesive capsulitis, no substantial range-of-motion deficit, no history of upper-limb fractures, no repeated shoulder dislocations, and no neck-related pain. Images in the coronal, sagittal, and axial planes withT1,T2, and proton density sequences were generated and independently and randomly interpreted by 2 examiners: a board-certified, fellowship-trained orthopedic shoulder surgeon and a musculoskeletal radiologist. Absolute and relative frequencies for each MRI finding were calculated and compared between symptomatic and asymptomatic shoulders. Agreement between the shoulder surgeon and the radiologist was also determined. Results Abnormal MRI findings were highly prevalent in both shoulders. Only the frequencies of full-thickness tears in the supraspinatus tendon and glenohumeral osteoarthritis were higher (approximately 10%) in the symptomatic shoulder according to the surgeon’s findings. Agreement
between the musculoskeletal radiologist and shoulder surgeon ranged from slight to moderate (0.00-0.51). Conclusion Most abnormal MRI findings were not different in frequency between symptomatic and asymptomatic shoulders. Clinicians should be aware of the common anatomic findings on MRI when considering diagnostic and treatment planning.
RodrigoPyGonçalvesBarretoPT,PhDaJonathanP.BramanMDbPaulaM.LudewigPT,PhDcdLarissa PechinchaRibeiroPT, MScaPaula RezendeCamargoPT, PhDa
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We are excited to have recently started using Shockwave Therapy on many patients with excellent results. Extracorporeal (outside the body) ShockWave therapy,useshigh-energysoundwavestargeted over a specific site over a short period of time, which helps stimulate certain components involved in the healing process. Research has shown that it can reduce pain, swellingand increasefunction inseveralchronic tendon disorders including tennis elbow, patella tendinopathy, Achilles tendinopathy, gluteal tendinopathy, rotator cuff tendinopathy of the shoulder and plantar fasciitis. A buildup of specific elements in the muscles or tendons creates local, painful conditions that are addressed with ShockWave therapy. Plastic surgeons are also requesting ShockWave therapy for post-surgical healing and scar treatments. In the UK, the National Institute of
Health endorses the use of ShockWave therapy to treat several of the conditions listed above due to the significant effects that it can have. A cluster of three to five sessions takes place across one to two weeks, followed by a gap of a few weeks for tissue regeneration. The picture of recovery is an accelerated progression from pain and mobility restoration.
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