title: Acromioclavicular joint arthrosis in persons with spinal cord injury and able-bodied persons.
abstract: OBJECTIVE
  To compare the prevalence, severity and risk of acromioclavicular (AC) joint arthrosis in persons presenting with shoulder pain between a spinal cord injury (SCI) and able-bodied population. In the SCI population, prevalence and severity of AC joint arthrosis were examined with respect to age, gender and lesion characteristics.
  
  
  METHODS
  Retrospective analysis of medical records and magnetic resonance images (MRI) collected in an outpatient orthopaedics clinic.
  
  
  RESULTS
  Sixty-eight persons with SCI and 105 able-bodied persons were included in the study. The overall MRI prevalence of AC joint arthrosis was 98% and 92%, respectively. In both groups AC joint arthrosis was frequently accompanied by MRI diagnosis of rotator cuff tears and biceps tendon ruptures. Sensitivity of clinical testing was found to be low in SCI (0.31) and in able-bodied persons (0.24). The odds of increasingly severe arthrosis were nearly four times higher in persons with SCI as compared with able-bodied persons (P<0.0001), about 72% lower in females as compared with males (P=0.0001), and 10% higher per additional year of age (P<0.0001). Arthrosis severity in the SCI-group was weakly associated with time since injury, not with neurological classification of SCI or level of injury (paraplegia vs tetraplegia).
  
  
  CONCLUSIONS
  SCI patients presenting with shoulder pain showed similar prevalence, yet more advanced, AC joint arthrosis than able-bodied patients. As early diagnosis of arthrosis is a prerequisite for the initiation of successful conservative interventions of shoulder deterioration, we recommend routine assessment of shoulder status including diagnostic imaging during check-ups.
authors: Swiss Paraplegic Research, Nottwil, Switzerland. inge.eriks@paranet.ch
authors: I
authors: I
authors: Eriks-Hoogland
authors: R
authors: R
authors: Engisch
authors: M W G
authors: MW
authors: Brinkhof
authors: S
authors: S
authors: van Drongelen
mesh_terms: D000173:Acromioclavicular Joint / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000150:complications* / Q000453:epidemiology* / Q000473:pathology; D004185:Disability Evaluation; D004487:Edema / Q000150:complications / Q000453:epidemiology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D012306:Risk; D012307:Risk Factors; D012737:Sex Factors; D020069:Shoulder Pain / Q000150:complications / Q000453:epidemiology / Q000473:pathology; D013119:Spinal Cord Injuries / Q000150:complications* / Q000453:epidemiology* / Q000473:pathology; D013557:Switzerland / Q000453:epidemiology; D055815:Young Adult