Shoulder diagnoses in secondary care, a one year cohort

Abstract

BackgroundShoulder pain is common in the general population. Reports on specific diagnoses in general populations are scarce and only from primary care. The diagnostic distribution of shoulder disorders in secondary care is not reported. Most of the clinical research in the shoulder field is done in hospital settings. The aim of this study was to identify the diagnoses in a 1-year cohort in a hospital-based outpatient clinic using standardized diagnostic criteria and to compare the results with previous studies.MethodsA diagnostic routine was conducted among patients referred to our physical medicine outpatient clinic at Oslo University Hospital. Diagnostic criteria were derived from the literature and supplemented with research criteria.ResultsOf 766 patients diagnosed, 55% were women and the mean age was 49 years (range 19–93, SD ± 14). The most common diagnoses were subacromial pain (36%), myalgia (17%) and adhesive capsulitis (11%). Subacromial pain and adhesive capsulitis were most frequent in persons aged 40–60 years. Shoulder myalgia was most frequent in age groups under 40. Labral tears and instability problems (8%) were most frequent in young patients and not present after age 50. Full-thickness rotator cuff tears (8%) and glenohumeral osteoarthritis (4%) were more prevalent after the age of 60. Few differences were observed between sexes. We identified three studies reporting shoulder diagnoses in primary care.ConclusionSubacromial pain syndrome, myalgia and adhesive capsulitis were the most prevalent diagnoses in our study. However, large differences in prevalence between different studies were found, most likely arising from different use of diagnostic criteria and a difference in populations between primary and secondary care. Of the diagnoses in our cohort, 20% were not reported by the studies from primary care (glenohumeral osteoarthritis, full thickness rotator cuff tears, labral tears and instabilities).

Prevalence of shoulder disorders in tertiary care centre

“…1,16,17 GH arthritis was seen in 10.0% of cases and rotator cuff injury was 13.1% in our study which is slightly higher than reported by other worker. 18 But this agrees well with the fact that we expect a higher proportion of cases with a definite diagnosis in patients referred to a tertiary care centre as compared to a primary and secondary care centre.…”

“…17 Most of the studies have reported subacromial pain syndrome as the most common cause of pain ranging from 30% to 86% of cases but we found subacromial pain in only 13.8% cases. 1,[16][17][18] The three previous studies reporting results of primary care centre population do not mention rotator cuff injury or GH arthritis as cause of shoulder pain. 1,16,17 GH arthritis was seen in 10.0% of cases and rotator cuff injury was 13.1% in our study which is slightly higher than reported by other worker.…”

Comparing of the Efficacy and Effectiveness of Isokinetic Exercise, Laser, Pseudoiontophoresis and Iontophoresis Treatments According to the Stage in Treatments of Subacromial Impingement Syndrome

“…13,14 Çalış-mamızda hastaların 79'u erkek, 163'ü kadındı. Ağrı hastayı hekime getiren en önemli semptomdur, özellikle de ağrı nedeniyle hekimlere en fazla baş-vuruyu kadınlar yapar.…”

“…SSS'de dominant taraf ile tutulan taraf arasında ilişki saptanmamıştır. 13,14 Çalışmamızda da ilişkili bulgu yoktu. SSS'nin etiyolojisi sadece dış etkenlere bağlı olsaydı SSS'nin dominant tarafta görülmesi gerekirdi.…”

Shoulder and Neck Pain: Interdisciplinary Aspects of Treatment

“…У 766 норвежских больных, предъяв-лявших жалобы на боль в плече, наиболее распростра-ненными диагнозами были субакромиальный синдром (36%), миалгия (17%) и адгезивный капсулит (11%). Первичный артроз плечевого сустава в данном исследо-вании встречался всего в 4% случаев и только у лиц стар-ше 60 лет, при этом не имелось гендерных различий [18]. В данной возрастной группе не следует забывать о такой социально значимой проблеме, как остеопороз.…”