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KMID : 1195520140070010001
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Journal of Korean Orthopaedic Ultrasound Society
2014 Volume.7 No. 1 p.1 ~ p.6
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Usefulness of Ultrasonographic Examination in Diagnosis and Follow-up of the Frozen Shoulder
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Choi Chang-Hyuk
Kim Seok-Jun
Lee Sang-Hwa
Kim Hee-Soo
Sim Jung-Hyun
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Abstract
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Purpose: In order to know the effectiveness of ultrasonographic examination in diagnosis and follow-up evaluation for the frozen shoulder, we compared those with contralateral side in initial and after steroid injection.
Materials and Methods: For the 20 unilateral frozen shoulder from July 2012 to July 2013, ultrasonographic examination was tried using reference line 1 (CBT: distance from coracoid process to LHB tendon) and line 2 (CBG: distance from coracoid process to bicipital groove). We tried 1 time steroid injection and compared the improvement in gross motion and reference line with 2 month, 4 month, and 6 month’s serial ultrasonographic examination.
Results: The differences on CBT line between lesion side and normal side were -5.6 mm, -5.0 mm, and -4.3 mm in neutral (Neut), external rotation (ER) and internal rotation (IR), respectively. The differences on CBG line were -6.1 mm, -4.7 mm, and -5.0 mm respectively (p<0.05). The changes in the reference line after steroid injection were evaluated at 2 month (CBT: -4.8 mm, -3.5 mm, -2.6 mm / CBG: -4.7 mm, -4.0 mm, -3.6 mm), 4 month (CBT: -4.7 mm, -3.2 mm, -1.7 mm / CBG: -4.3 mm, -3.7 mm, -1.2 mm), and 6 month (CBT: -1.1 mm, -2.9 mm, -0.5 mm / CBG: -1.2 mm, -0.7 mm, - 0.9 mm). The gross motion was improved at 4 month after injection, from elevation 108°, ER 32°, IR L5 in initial to 133°, 42°, L3 respectively (p<0.05). Pain improved from 7.5 in initial to 3.0 at 2 month on visual analog scale (VAS).
Conclusion: The serial examination after steroid injection revealed that the delayed improvement on reference line (6 month) compared with pain (2 month) or gross motion (4 month). Dynamic ultrasonogram was useful in diagnosis and follow-up evaluation of frozen shoulder.
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KEYWORD
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Frozen shoulder, Ultrasonogram, Steroid Injection
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