title: Increased blood flow in the anterior humeral circumflex artery correlates with night pain in patients with rotator cuff tear.
abstract: BACKGROUND
  Night pain is a particularly vexing symptom in patients with rotator cuff tear. It disturbs sleep and decreases quality of life, and there is no consensus regarding its etiology. Based on arthroscopic surgical observations of synovitis around the rotator interval or capsule surface in rotator cuff tear, we hypothesized that blood flow from the artery feeding the capsule increases blood supply to the synovium. This study aimed to investigate the relationship between blood flow and night pain using pulse Doppler ultrasonography.
  
  
  METHODS
  A series of 47 consecutive patients with rotator cuff tear was evaluated. The peak systolic velocity and resistance index of blood flow in the ascending branch of the anterior humeral circumflex artery were evaluated using pulse Doppler ultrasonography. We also investigated 20 normal shoulders in healthy volunteers. The peak systolic velocity and resistance index were compared between affected and unaffected sides in patients and between dominant and nondominant sides in controls.
  
  
  RESULTS
  Anterior humeral circumflex artery peak systolic velocity and resistance index did not differ between sides in control subjects or in patients with rotator cuff tear without night pain. However, anterior humeral circumflex artery peak systolic velocity and resistance index did differ significantly between sides in patients with rotator cuff tear with night pain.
  
  
  CONCLUSIONS
  This study revealed anterior humeral circumflex artery hemodynamics in patients with rotator cuff tear and normal subjects using Doppler ultrasonography. Night pain, particularly involving aching, appears to be related to the hemodynamics. These findings suggest that investigating the hemodynamics of patients with rotator cuff tear with night pain may lead to greater understanding of the etiology of this symptom.
authors: Department of Orthopaedic Surgery, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, Gifu, 501-1194, Japan, jirin1022@yahoo.co.jp.
authors: Nobuo
authors: N
authors: Terabayashi
authors: Tsuneo
authors: T
authors: Watanabe
authors: Kazu
authors: K
authors: Matsumoto
authors: Iori
authors: I
authors: Takigami
authors: Yoshiki
authors: Y
authors: Ito
authors: Masashi
authors: M
authors: Fukuta
authors: Haruhiko
authors: H
authors: Akiyama
authors: Katsuji
authors: K
authors: Shimizu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity; D016022:Case-Control Studies; D002940:Circadian Rhythm; D005260:Female; D006801:Humans; D017746:Joint Capsule / Q000098:blood supply* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow; D017006:Rotator Cuff / Q000000981:diagnostic imaging; D000070636:Rotator Cuff Injuries; D012785:Shoulder Joint / Q000098:blood supply* / Q000000981:diagnostic imaging; D020069:Shoulder Pain / Q000000981:diagnostic imaging / Q000209:etiology*; D013585:Synovitis / Q000150:complications* / Q000000981:diagnostic imaging; D013708:Tendon Injuries / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D014463:Ultrasonography; D014655:Vascular Resistance