The Diagnosis and Prognosis of Impingement Syndrome in the Shoulder with Using Quantitative SPECT Assessment: A Prospective Study of 73 Patients and 24 Volunteers

Abstract

BackgroundDiagnosing impingement syndrome without rotator cuff tear usually depends on the physical examination and roentgenography, and obtaining objective evidence for this condition is at best difficult. The purpose of this study was to ascertain whether quantitatively assessing this condition with using single photon emission computerized tomography (SPECT) can diagnose impingement syndrome and predict the postoperative results.MethodsBefore executing arthroscopic or open treatment, SPECT was performed on 73 patients and 24 volunteers and these people were followed up for 2 years. Any increased uptake on SPECT was investigated by using the axial view, which demonstrated the greatest uptake for the acromion, distal clavicle, greater tuberosity, lesser tuberosity and the coracoid process of the operated and non-operated sides.ResultsThe patients who were diagnosed as having impingement syndrome with or without rotator cuff tear showed increased uptake on the operative side compared to the non-operated side in the assessed locations. The greater tuberosity of the humerus could be used for quantitative measurement as a postoperative prognostic factor.ConclusionsThe bone SPECT method is useful for making the diagnosis of patients with impingement sydrome, and the results of quantitative assessment at the greater tuberosity can be used for evaluating the prognosis following the operation.

Shoulder impingement syndrome: a systematic review of clinical trial participant selection criteria

“…The full text articles of the remaining 116 studies were examined for eligibility and 97 studies were identified for inclusion in the review. 7,13, …”

“…Interestingly, US was found to be a valuable diagnostic tool in several studies for rotator cuff complete or incomplete tears, MRI was indicated to be accurate in determining Hills-Sach lesions or bony lesions, and MRA was found to be superior in accurately diagnosing labral capsular ligamentous complex lesions such as internal subacromial impingement. 7,114 This research can be used as an aid for the development of diagnostic and treatment protocols. It highlights the most current methods used to diagnose SIS and can help clinicians reflect on what truly defines a case of impingement syndrome.…”

“…However, the literature contains no suitable definition for the diagnosis of SIS using ultrasound and magnetic resonance imaging where such investigations play only a supporting role in the exclusion of other conditions. 7,[12][13][14] Multidisciplinary consensus on the clinical criteria used to define SIS is important to avoid inappropriate surgical or nonsurgical intervention and to facilitate the direct comparison of outcomes of various treatment options. If there is no consensus on the selection criteria of study participants between professions and levels of evidence, it is difficult to compare outcomes of various treatment options effectively.…”

“…Many studies highlight the difficulty in differentiating impingement from other shoulder pathologies, where shoulder pain can be indicative of other conditions such as joint instability, cervical radiculopathy, calcific tendinitis, adhesive capsulitis, degenerative joint disease, acromioclavicular osteoarthrosis and nerve compression. 2,[5][6][7] Consequently, the use of the term SIS as a diagnostic label has been the subject of debate, as it has been used for a spectrum of other shoulder and cervical conditions 5,6,[8][9][10][11] Diagnosis of SIS often relies upon a combination of physical examinations and further radiological investigations. However, the literature contains no suitable definition for the diagnosis of SIS using ultrasound and magnetic resonance imaging where such investigations play only a supporting role in the exclusion of other conditions.…”

Klinische oder radiologische Diagnose des Impingements

“…Dabei handelt es sich vorwiegend um die 99m Technetium-Szintigraphie [21] und quantitative Einzelphotonenemissionscomputertomographie (SPECT [22]), welche sich zumindest im deutschsprachigen Raum jedoch bislang nicht in der Routine durchgesetzt haben.…”