Arthrographic and clinical findings in patients with hemiplegic shoulder pain11No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.

Lo, Sui-Foon; Chen, Shu-Ya; Lin, Hong‐Ping; Jim, Yick-Fung; Meng, Nai‐Hsin; Kao, Ming‐Ching

doi:10.1016/s0003-9993(03)00408-8

Cited by 123 publications

(37 citation statements)

References 10 publications

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“…These findings are generally in agreement with the works of previous researchers [16,17,20–24] but differ from others who reported SASD effusion [2,9,13] and adhesive capsulitis [25–27] as their main findings. The differences could be due partly to the fact that those with coexisting LHBT/SASD effusions were not separated from those with isolated SASD effusion and isolated LHBT effusion during the data analysis, possibly increasing the frequency of both findings.…”

Section: Discussionsupporting

confidence: 85%

Sonographic Evaluation of Structural Changes in Post-Stroke Hemiplegic Shoulders

et al. 2018

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SummaryBackgroundStroke and hemiplegia are frequent complications of stroke. This study was performed to sonographically evaluate post-stroke hemiplegic shoulders and explore possible relationship(s) between the sonographic findings and clinical indices.Material/MethodsForty-five stroke patients and 45 age- and sex-matched controls were recruited. Standard sonographic examination of both shoulders was performed to assess for joint subluxation, rotator cuff tears, tendinosis, subacromial-subdeltoid bursitis or effusion and adhesive capsulitis.ResultsHemiplegic shoulders exhibited significantly higher number of pathologies compared to the unaffected shoulders and shoulders of controls (p=0.000). One or more structural abnormalities were found in all 45 (100%) hemiplegic shoulders, 25 (55.6%) unaffected shoulders of the stroke subjects, and 39 (43.3%) control shoulders. The most frequent pathologies in the hemiplegic shoulders were the following: tendinosis of the long head of bicep tendon (48.9%), inferior shoulder subluxation (44.4%), co-existing subacromial-subdeltoid bursa/long head of bicep tendon sheath effusion (44.4%), and long head of bicep tendon sheath effusion only (40%). Tendinosis of the long head of bicep tendon was commoner in hemiplegic shoulders with poor motor status than those with good motor status.ConclusionsHemiplegic shoulders have significantly higher number of structural abnormalities than unaffected shoulders and the shoulders of controls. Hemiplegic stroke patients should undergo ultrasonography of the hemiplegic shoulder to define the nature and extent of soft tissue injuries prior to physical therapy.

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Section: Discussionsupporting

confidence: 85%

Sonographic Evaluation of Structural Changes in Post-Stroke Hemiplegic Shoulders

et al. 2018

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“…thalamic pain [5], shoulder muscle spasticity or flaccidity [6]), sympathetic dystrophy [7] and orthopedic abnormalities [8,9] (i.e. impingement [10], rotator cuff tears [11], supraspinatus tendinosis [12], subacromial-subdeltoid bursal effusion [12,13], tendon sheath effusion of biceps long head [12,13] and adhesive capsulitis [14]). No clear correlations have emerged from either ultrasound or arthrographic studies, and a multifactorial pathogenesis of HSP has been proposed [12].…”

Section: Introductionmentioning

confidence: 99%

Enhanced-MRI and Ultrasound Evaluation of Painful Shoulder in Patients after Stroke: A Pilot Study

et al. 2011

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Background: Epidemiological and radiological studies have previously been performed to identify the possible causes of hemiplegic shoulder pain (HSP). Many different etiologies have been postulated, though no clear correlations have emerged, and a multifactorial pathogenesis of HSP has been proposed. Recently, two MRI-based studies have described different shoulder findings as possible causes of pain in chronic stroke survivors. Purpose: The aim of this study was to describe the structural abnormalities of the painful shoulder in the first months after stroke by ultrasound and enhanced MRI. The secondary aims were to identify possible predisposing factors for HSP and to evaluate its impact on motor recovery. Methods: One hundred and fifty-three first-time stroke patients, admitted to the Santa Lucia Foundation for rehabilitation, were investigated for HSP. Twenty-five stroke patients with HSP and 16 stroke patients without shoulder pain were included. An ultrasound evaluation and enhanced shoulder MRI were performed for all the patients. Results: Among the shoulder abnormalities detected by both imaging studies, only capsulitis, which was detected by enhanced shoulder MRI in 88% of the HSP patients, was independently associated with pain (p < 0.001) and proven to be predictive of pain intensity as expressed by the VAS score (p < 0.003). HSP correlated with a worse global recovery (p < 0.05) as well as with male sex (p = 0.006), neglect (p = 0.02) and subluxation (p = 0.03), although none of these features were found to be independent predictors of pain. Conclusion: Adhesive capsulitis was found to be a possible cause of HSP. However, MRI, which is more expensive than other diagnostic tools, may be considered the gold standard tool for understanding the etiology of HSP.

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“…Lo et al [22] reported that 50% of the hemiplegic shoulder pain on the affected side is contractured articular inflammation, 44% is shoulder subluxation, 22% is rotator cuff damage, and 16% is complex regional pain syndrome. Persons with hemiplegic shoulder pain often have more than two factors that cause the pain [13,22].…”

Section: Discussionmentioning

confidence: 99%

The Comparison of Effects of Suprascapular Nerve Block, Intra-articular Steroid Injection, and a Combination Therapy on Hemiplegic Shoulder Pain: Pilot Study

et al. 2014

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ObjectiveTo assess the relative effectiveness of three injections methods suprascapular nerve block (SSNB) alone, intra-articular steroid injection (IAI) alone, or both-on relief of hemiplegic shoulder pain.MethodsWe recruited 30 patients with hemiplegic shoulder pain after stroke. SSNB was performed in 10 patients, IAI in 10 patients, and a combination of two injections in 10 patients. All were ultrasonography guided. Each patient's maximum passive range of motion (ROM) in the shoulder was measured, and the pain intensity level was assessed with a visual analogue scale (VAS). Repeated measures were performed on pre-injection, and after injection at 1 hour, 1 week, and 1 month. Data were analyzed by Kruskal-Wallis and Friedman tests.ResultsAll variables that were repeatedly measured showed significant differences in shoulder ROM with time (p<0.05), but there was no difference according injection method. In addition, VAS was statistically significantly different with time, but there was no difference by injection method. Pain significantly decreased until a week after injection, but pain after a month was relatively increased. However, pain was decreased compared to pre-injection.ConclusionThe three injection methods significantly improved shoulder ROM and pain with time, but no statistically significant difference was found between them.

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Cited by 123 publications

References 10 publications

Sonographic Evaluation of Structural Changes in Post-Stroke Hemiplegic Shoulders

Sonographic Evaluation of Structural Changes in Post-Stroke Hemiplegic Shoulders

Enhanced-MRI and Ultrasound Evaluation of Painful Shoulder in Patients after Stroke: A Pilot Study

The Comparison of Effects of Suprascapular Nerve Block, Intra-articular Steroid Injection, and a Combination Therapy on Hemiplegic Shoulder Pain: Pilot Study

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