Study On The Pathogenesis Of Post-Stroke Shoulder Pain Based On The Characteristics Of Magnetic Resonance Imaging-A Retrospective Study

Abstract

Background High morbidity has been proved frequently happened in post-stroke shoulder pain (PSSP), but the specific pathogenesis of PSSP still remains unclear. Therefore, further research needs to be done to investigate this field. Objective The aim of this study which reviewed the features of magnetic resonance imaging (MRI) on shoulder joint of patients with PSSP, is to find the consequence of pathogenesis. Methods This study starts from June 2017 to August 2021, 74 PSSP patients who accepted MRI examination were selected in the Department of rehabilitation medicine of the Second Affiliated Hospital of Nanjing Medical University (inpatient and outpatient). This study sorted out and summarized patients’ MRI characteristics, analyzing differences of MRI appearance according to age, gender, hemiplegic side, stroke type and onset time. Results After examining all PSSP patients’ MRI characteristics, this study found 56 (75.67%) had supraspinatus tendon injury, 11 (14.86%) infraspinatus tendon injury, 24 (32.43%) subscapular tendon injury, 2 (2.7%) teres minor tendon injury, 60 (81.08%) tendon sheath effusion (inflammation) of long head of biceps brachii, 23 (31.08%) humeral head bone marrow edema and 64 (86.49%) shoulder joint capsule effusion. Moreover, there were 6 cases of acromial descending sac effusion (8.11%), 11 cases of coracoid descending sac effusion (14.86%), 8 cases of synovial thickening (10.81%), and 1 case of ossifying myositis (1.35%). Conclusion No significant differences were found in MRI features according to gender and hemiplegic side .The results showed the injury of supraspinatus tendon significantly increased in the older group compared to the younger group (P=0.039).The patients with supraspinatus tendon injury and tendon sheath effusion (inflammation) of long head of biceps brachii have higher cerebral infarction than patients with cerebral hemorrhage (P=0.002, P=0.028). Based on the time of onset, the participants were divided into three groups: within 1 month, 1–3 months and more than 3 months. The results suggested significant differences in humeral head bone marrow edema and shoulder joint capsule effusion numbers among the three groups (P=0.049, P=0.002). The results of this research could help to improve the accuracy of clinical diagnosis and treatment of PSSP, putting forward a more reasonable treatment scheme.