Subacromial Impingement Syndromeにおける超音波検査
1986 年 10 巻 1 号 p. 41-45
詳細
1986 年 10 巻 1 号 p. 41-45
Diagnosis for the subacromial impingement syndrome (S. I. S. ) including rotator cuff tears has been made by clinical signs and shoulder arthrography. However, some lesions in S. I. S. may not be identified with even arthrography and subacromial bursography. Recently, a few reports on the use of ultrasonorraphy (U. S. ) for S. I. S. has been found.
We have also performed U. S. for the S. I. S. preo p eratively and occasionally at operation. Based on our experience, indication and limitation of U. S. are discussed.
Material: 21 operated cases were evaluated: 5 in G rade I (subacromial bursitis and/or tendinitis),7 in Grade II (partial thickness cuff tear) and 9 in Grade III (full thickness cuff tear). There were 17 men and 4 women, whose ages ranged from 25 to 70 (mean 49).
Method: We used a real time ultrasound scanner (Hitachi EUB-40) and 7.5 MHz transducer with water bag and “Kitecko”(polymer gel).
Examination was performed in t he sitting position on bilateral supraspinatus tendons in both longitudinal and transverse planes.
Subsequently, dynamic s t u dies were also done by rotating the arm in the anatomical position. Following U. S., pathology was reconfirmed by surgery in all cases.
Result: U. S. findings are summerized as follows: In Grade I, the rotator cuff was thicker than that of normal side. In Grade II, irregularity was found in the sites of bursal side tear and rim rent. No findings have been obtained suggesting intratendinous tear in this series. In Grade III, heterogene'Ous and high level echogenicity and cuff defects were observed.
Conclusion: 1 U. S. is non-invasive and can be applied for the diagnosis of S. I. S. When combined with shoulder arthrography and subacromial bursography, the diagnostic accuracy is incresed.2 U. S. is a dynamic examination requiring multiphasic observations.3 U. S. is probably best, indicated for the intratendinous tears of the rotator cuff and intratendinous extensions of the partial thickness tears.4 In contrast to the clear visualization of cuff defects on the sonogram in most cases, interpretations may be subtle occasionally.
