肩峰下滑液包造影の臨床的意義

抄録

Subacromial impingement syndrome or rotator cuff tears are very common shoulder diseases which occur in the subacromial bursa. Subacromial injection of anesthetic during subacromial bursography is very helpful for understanding the pathological condition in the subacromial bursa. The aim of this study was to evaluate the correlation between visual change in the subacromial bursa and its pathology and to identify the significance of subacromial bursographies. We retrospectively evaluated subacromial bursographies of 133 shoulders in 133 patients (78 males, 55 females), who were diagnosed as having subacromial impingement in 71 cases, stiff shoulder in 39 cases, calcifying tendonitis in 5 cases, and partial thickness rotator cuff tear in 18 cases. We classified four types of bursographies based on the visualized portion such as subacromial portion: SA, subcoracoid portion: SC and subdeltoid portion: SD according to the Mikasa's classification. <Type 1: SA, Type 2: SA and SC, Type 3: SA and SD, Type 4: SA, SC and SD> Anesthetic was used during subacromial bursography; pain block effect and improvement of the shoulder motion were statistically analyzed. We observed 76 cases of type 1, 21 cases of type 2, 35 cases of type 3 and 1 case of type 4. There was a correlation between stiff shoulder and SA narrowed subtype in type 1. Pain block effect in type 2 was more significant than other types.Our results showed that four types of new image classification of subacromial bursography are helpful for understanding the pathology in subacromial bursa.