Clinical, socio-demographic and radiological predictors of short-term outcome in rotator cuff disease.
BACKGROUND
Shoulder pain is common with rotator cuff disease as the most frequently used clinical diagnosis. There is a wide range of treatment options for this condition, but limited evidence to guide patients and clinicians in the choice of treatment strategy. The purpose of this study was to investigate possible prognostic factors of short-term outcome after corticosteroid injection for rotator cuff disease.


METHODS
We performed analyses of data from 104 patients who had participated in a randomized controlled study. Socio-demographic, clinical and radiographic baseline factors were assessed for association with outcome at six-weeks follow-up evaluated by Shoulder Pain and Disability Index (SPADI) and patient perceived outcome. Factors with significant univariate association were entered into multivariate linear and logistic regression analyses.


RESULTS
In the multivariate analyses; a high SPADI score indicating pain and disability at follow-up was associated with decreasing age, male gender, high baseline pain and disability, being on sick-leave, and using regular pain medication. A successful patient perceived outcome was associated with not being on sick-leave, high active abduction, local corticosteroid injection and previous cortisone injections. Structural findings of rotator cuff tendon pathology on MRI and bursal exudation or thickening on ultrasonography did not contribute to the predictive model.


CONCLUSIONS
Baseline characteristics were associated with outcome after corticosteroid injection in rotator cuff disease. Sick-leave was the best predictor of poor short-term outcome.


BACKGROUND
Clinical trials NCT00640575.
Department of Physical Medicine and Rehabilitation, Oslo University Hospital Ullevål, Oslo, Norway. o.m.ekeberg@medisin.uio.no
Ole M
OM
Ekeberg
Erik
E
Bautz-Holter
Niels G
NG
Juel
Kaia
K
Engebretsen
Synnøve
S
Kvalheim
Jens I
JI
Brox
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000328:Adult; D017677:Age Distribution; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011859:Radiography; D017006:Rotator Cuff / Q000000981:diagnostic imaging* / Q000187:drug effects* / Q000473:pathology; D017678:Sex Distribution; D019534:Shoulder Impingement Syndrome / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D012959:Socioeconomic Factors; D013997:Time Factors
D000305:Adrenal Cortex Hormones