Shoulder impingement syndrome: relationships between clinical, functional, and radiologic findings.
OBJECTIVE
Although there has been much research about imaging methods for shoulder impingement syndrome, the clinical information and upper limb level of disability have been generally ignored. The purpose of this study was to detect the relationships between clinical, functional, and radiologic variables in patients with shoulder impingement syndrome.


METHODS
A cross-sectional, clinical, and radiologic study was planned and 59 shoulders of 58 consecutive patients waiting for physical therapy because of a clinically suspected shoulder impingement syndrome were included into this study. Comprehensive clinical examination, radiography, shoulder ultrasonography, and magnetic resonance imaging were performed in the same month.


RESULTS
Despite the high sensitivities of ultrasonography for diagnosing rotator cuff tears (98.1%) and biceps pathologies (100%), magnetic resonance imaging was superior to ultrasonography in many important shoulder structures such as a glenoid labral tear and subacromial bursal effusion/hypertrophy (P < 0.01). These structures were the determinants of the shoulder's disability measured by disabilities of the arm, shoulder, and hand questionnaire.


CONCLUSIONS
Ultrasonography and magnetic resonance imaging had comparable high accuracy for identifying the biceps pathologies and rotator cuff tears. The basic clinical tests had modest accuracy in both disorders. The choice of which imaging test to perform should be based on the patient's clinical information (regarding lesion of glenoid labrum, joint capsule, muscle, and bone), cost, and imaging experience of the radiology department.
Ardic
Figen
F
Division of Hand Rehabilitation, Department of Physical Medicine and Rehabilitation I, Ankara Education and Research Hospital, Turkey
Kahraman
Yasar
Y
Kacar
Mahmut
M
Kahraman
Mehmet Cemal
MC
Findikoglu
Gulin
G
Yorgancioglu
Z Rezan
ZR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002062:Bursitis / Q000150:complications / Q000175:diagnosis; D003430:Cross-Sectional Studies; D006801:Humans; D006984:Hypertrophy / Q000150:complications / Q000175:diagnosis; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D016059:Range of Motion, Articular; D000070636:Rotator Cuff Injuries; D012680:Sensitivity and Specificity; D019534:Shoulder Impingement Syndrome / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D020069:Shoulder Pain / Q000175:diagnosis / Q000209:etiology; D052256:Tendinopathy / Q000150:complications / Q000175:diagnosis; D014463:Ultrasonography