The authors declare that they have no competing interests.
RPGO, IGMK, LMMS, RAB, GJD and JWLC participated in the study concept and design. RPGO, IGMK and LMMS participated in the acquisition of data and the statistical analysis. RPGO, IGMK, LMMS, KV, RAB, GJD and JWLC contributed to the analysis and interpretation of data. RPGO, IGMK, LMMS and JWLC participated in the drafting of the manuscript. RPGO, IGMK, LMMS, KV, RAB, GJD and JWLC participated in the critical revision of the manuscript for important intellectual content. All authors read and approved the final manuscript.
Ultrasound imaging (US) is considered an accurate and widely available method to diagnose subacromial disorders. Yet, the frequency of the specific US-diagnosed shoulder disorders of patients with shoulder pain referred from general practice is unknown. We set out to determine the frequency of specific US-diagnosed shoulder disorders in daily practice in these patients and to investigate if the disorders detected differ between specific subgroups based on age and duration of pain.
A predefined selection of 240 ultrasound reports of patients with shoulder pain (20 reports for each month in 2011) from a general hospital (Orbis Medical Centre Sittard-Geleen, The Netherlands) were descriptively analysed. Inclusion criteria were: (i) referral from general practice, (ii) age ≥18 years, and (iii) unilateral shoulder examination. Subgroups were created for age (<65 years and ≥65 years) and duration of pain (acute or subacute (<12 weeks) and chronic (≥12 weeks)). The occurrence of each specific disorder is expressed as absolute and relative frequencies.
With 29%, calcific tendonitis was the most frequently diagnosed disorder, followed by subacromial-subdeltoid bursitis (12%), tendinopathy (11%), partial-thickness tears (11%), full-thickness tears (8%) and AC-osteoarthritis (0.4%). For 40% of patients, no disorders were found on US. Significantly more full thickness-tears were found in the ≥65 years group. ‘No disorders’ was reported significantly more often in the <65 years group. The supraspinatus tendon was the most frequently affected tendon (72%).
Calcific tendonitis is the most common US-diagnosed disorder affecting patients in general practice, followed by subacromial-subdeltoid bursitis, tendinopathy, partial- and full-thickness tears and AC-osteoarthritis. Full-thickness tears were diagnosed significantly more frequently in patients ≥65 years, while ‘no disorders’ was more frequently reported in patients <65 years. Our findings imply that patients can be stratified into diagnostic subgroups, allowing more tailored treatment than currently applied.
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- Ultrasound-diagnosed disorders in shoulder patients in daily general practice: a retrospective observational study
Ramon PG Ottenheijm
Inge GM van’t Klooster
Laurens MM Starmans
Rob A de Bie
Jochen WL Cals
- BioMed Central
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