Quantitative Ultrasonographic Analysis of Changes of the Suprascapular Nerve in the Aging Population With Shoulder Pain

Abstract

BackgroundOlder people are vulnerable to painful shoulder syndromes, the majority of which are derived from degenerative rotator cuff pathologies. The suprascapular nerve (SSN) is closely related to the rotator cuff complex, and its role in shoulder pain has recently been highlighted. This study aimed to explore the differences in SSN among older people with and without shoulder pain, and to investigate the potential factors influencing the nerve size using ultrasound (US) imaging.MethodsParticipants aged ≥60 years were enrolled in the study. A systematic and bilateral US examination of the rotator cuff tendons was performed. The SSN was examined from its origin in the brachial plexus to the spinoglenoid notch of the infraspinatus fossa. The association between the nerve’s cross-sectional area (CSA) and rotator cuff lesions was analyzed using the generalized estimation equation.ResultsAmong the 94 participants, 45 (with bilaterally asymptomatic shoulders) were classified into the control group, whereas 49 (with at least one-sided shoulder pain) were classified into the group with shoulder pain. The average CSAs of the SSN at the level of the brachial plexus, supraspinatus fossa, and infraspinatus fossa were comparable between the patients in the control group and those with shoulder pain. There was a higher prevalence of rotator cuff lesions and enlarged distal SSNs in the painful shoulders than in the asymptomatic shoulders of patients with unilateral involvement. A full-thickness tear of the supraspinatus tendon was associated with swelling of the SSN in the supraspinatus fossa (β coefficient = 4.068 mm2, p < 0.001).ConclusionIn the older population, full-thickness tears of the supraspinatus tendon are independently associated with enlargement of the distal SSN. In cases with large rotator cuff tendon tears with poor response to conservative treatments, possible SSN entrapment should be considered and managed accordingly.

Sarcopenia Is Associated With Increased Risks of Rotator Cuff Tendon Diseases Among Community-Dwelling Elders: A Cross-Sectional Quantitative Ultrasound Study

“…Thickness and echogenicity measurements were conducted on the long axis of the tendon using the straight-line tool and histogram function of the image processing software, Image J ( Supplementary Figure 1 ) ( 15 , 24 ). A line was drawn perpendicular to the most proximal end of the bicipital groove until it reached the superficial border of the tendon to measure the thickness of the biceps long head tendon ( Figure 1A ).…”

“…Rotator cuff tendon tears are regarded as the most detrimental type of shoulder tendon disorders and frequently lead to severe disability. In recent years, high-resolution ultrasound has been widely used in the evaluation of rotator cuff tendon disorders (13)(14)(15), and its diagnostic accuracy is comparable to that of magnetic resonance imaging (16). In contrast to reports of descriptive findings, quantitative measurements of thickness, and echo intensity provide more objective assessments of tendon texture.…”

Concurrent Validity and Reliability of Manual Versus Specific Device Transcostal Measurements for Breathing Diaphragm Thickness by Ultrasonography in Lumbopelvic Pain Athletes

“…Several tools, such as electromyography, magnetic resonance imaging (MRI), and ultrasound (US) were valid and reliable for assessing static and dynamic functioning under different conditions for which the RUSI technique is considered as a non-invasive, valid, and reliable approach at rest and during activity of the trunk deep stabilizer muscles [ 11 , 12 ]. The benefits of US in musculoskeletal systems have been described for evaluating different soft tissues, such as nerves, joints, tendons, and muscles [ 13 , 14 ].…”

A Novel Approach to New-Onset Hemiplegic Shoulder Pain With Decreased Range of Motion Using Targeted Diagnostic Nerve Blocks: The ViVe Algorithm

“…It is important to rule out preexisting causes or common causes such as rotator cuff tendinopathy or osteoarthritis, as well as acquired plexus or lower motor traction injuries from the handling of the hemiplegic shoulder (48,49). There is evidence showing that swollen suprascapular nerves might be related to painful shoulders in the aging population (50). Resistance to movement commonly coincides most with both capsulitis and spastic muscle overactivity.…”