Ultrasonographic features in pathological changes of shoulder joint’s periarticular tissues in patients with different manifestations of pain syndrome
Tendonitis of muscles which provide movements in the shoulder joint (SJ), osteochondrosis of cervical or thoracic spine, secondary vertebrogenic radiculopathy commonly is cause pain and limitation of motor activity in the shoulder girdle area. Objective: to identify the peculiarities of pathological changes in anatomical structures of SJ at pain syndrome at various nosology. Methods: 206 patients (18–65 years old) were examined and divided into three groups: I — control, II — shoulder impingement syndrome (SIS) at spinal degenerative disc disease, III — SIS of unknown etiology. Ultrasound data were analyzed. Results: it was found that in healthy people there were age-related ultrasound changes in the structure of tendons, ligaments, muscles and SJ cartilages which did not cause discomfort. Changes were found in 10 % of people in a subgroup of 30–40 years of age, and in 30–45 % in older ones. Thicknesses of the capsule, tendons, ligaments and muscles were almost equal (symmetrical) on contralateral joints. The absolute difference in soft-tissue structures’ thickness did not exceed 0.2 mm, the asymmetry coefficient was 0.96. In group II, there were almost no changes in the structure of SJ’s periarticular tissues. The absolute difference in anatomical structures’ thickness was 0.2 mm, the asymmetry coefficient of thickness of the affected and intact joints’ anatomical structures was more than 0.95. In group III, the largest disorders were observed: the echogenicity of affected SJ structures was reduced in more than 90 % of patients; in one third — a heterogeneous structure with hyperechoic inclusions was observed. The absolute difference in thickness of anatomical structures on affected limb comparing with those on the healthy one was more than 0.5 mm, the asymmetry coefficient was less than 0.95. Conclusions: using obtained data, we divided the group with SIS during initial examination, according to the presence of structural changes in the SJ’s periarticular tissues, in order to choose the treatment tactics subsequently.
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