Ultrasound and magnetic resonance findings and correlation in hemiplegic patients with shoulder pain.
BACKGROUND
The aim of this study was to evaluate the ultrasonography (US) and MRI findings in hemiplegic patients with shoulder pain and investigate the correlation between them. It is not possible for these patients to fully perform active range of motion (ROM) and stress tests, so imaging methods take center stage in diagnosis and treatment planning.


METHODS
A total of 68 hemiplegic patients with shoulder pain attending the inpatient rehabilitation program were included in the study. MRI and US results from the patient files were recorded. The frequency of each pathology identified by US and MRI was determined. The distribution of MRI and US findings was investigated to see whether there was a statistical difference between the correlation of MRI and US results.


RESULTS
The mean (SD) age of the patients was 63.7 (8.3) years and the mean (SD) duration of hemiplegia was 49 (8.9) days. According to the MRI results, glenohumeral and acromioclavicular joint degeneration was found in 77.9% and 79.7% of the patients, respectively; subacromial-subdeltoid bursitis in 80.9%; fluid increase in the joint space in 41.2%; supraspinatus tendinitis in 36.8%; and supraspinatus partial rupture in 33.8%. Shoulder US findings were supraspinatus tendinitis in 54.4%, acromioclavicular joint degeneration in 26.5%, bicipital tendinitis in 20.6%, and subacromial-subdeltoid bursitis in 19.1%. There was a statistically significant difference between MRI and US findings. The results were not compatible with each other (P ≯ .05), and these findings were not consistent with each other since the kappa coefficient was under 0.40 for all these results.


CONCLUSIONS
Although US is recommended as the first method in determining shoulder pathologies in hemiplegic patients, we suggest that MRI should be used as the first choice in hemiplegic patients with shoulder pain. MRI and US findings were not consistent, and US is dependent on the experience of the operator. MRI should be the first choice in cases where the diagnosis will affect the treatment choice due to the lack of correlation between US and MRI findings.
Department of Physical Medicine and Rehabilitation, Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey.
Asuman
A
Doğun
Department of Physical Medicine and Rehabilitation, Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey.
İlkay
İ
Karabay
Department of Radiology, Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey.
Cem
C
Hatipoğlu
Department of Physical Medicine and Rehabilitation, Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey.
Neşe
N
Özgirgin
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006429:Hemiplegia / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000534:rehabilitation; D006801:Humans; D007592:Joint Diseases / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging / Q000473:pathology; D011237:Predictive Value of Tests; D016059:Range of Motion, Articular / Q000502:physiology; D018401:Sample Size; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000473:pathology; D020069:Shoulder Pain / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000534:rehabilitation; D020521:Stroke / Q000000981:diagnostic imaging* / Q000473:pathology*; D000071939:Stroke Rehabilitation; D014463:Ultrasonography
hemiplegic shoulder pain; magnetic resonance imaging; ultrasonography