Abstract：
OBJECTIVE: The shoulder pain is one of the main causes that lead the patient to medical evaluation. Today, the ultrasound (US) represents an essential tool in the orthopaedical, rheumatological and rehabilitative setting to address the musculoskeletal causes of pain. Amongst the commonest causes of shoulder complains lay the frequent subacromial chronic bursitis (SACB). In this condition, the thickening of the bursal walls and subsequent fusion of the two synovial sheets leads to the reciprocal loss of bursal walls gliding under the subacromial space and consequently pain. This condition represents a common cause of shoulder pain and may be easily addressed by musculoskeletal sonographers. The purpose of this paper will be to describe the US appearance of SACB and to evaluate the efficacy of US-guided hydrodilation in its treatment.
METHODS: We included patients with painful shoulder attending our outpatient clinic for shoulder complains with the diagnosis of SACB with a bursal wall > 1.5 mm. A group was treated via US-guided hydrodilation, while the control group was treated via a classical blind approach using triamcinolone acetonide. Both groups underwent the same rehabilitation program following the injections. The shoulder functionality was assessed via qDASH questionnaire at baseline, days 3, 7, 14, 30, 60, and 90. A p <0.05 was considered significant.
RESULTS: Both groups displayed a significant reduction of pain; nevertheless, in the group treated with US-hydrodilation, there was no need for re-treatment.
CONCLUSIONS: The US-guided hydrodilation for SACB should be the preferred technique to detach bursal walls and improve patient symptoms, since it requires fewer invasive maneuvers.
METHODS: We included patients with painful shoulder attending our outpatient clinic for shoulder complains with the diagnosis of SACB with a bursal wall > 1.5 mm. A group was treated via US-guided hydrodilation, while the control group was treated via a classical blind approach using triamcinolone acetonide. Both groups underwent the same rehabilitation program following the injections. The shoulder functionality was assessed via qDASH questionnaire at baseline, days 3, 7, 14, 30, 60, and 90. A p <0.05 was considered significant.
RESULTS: Both groups displayed a significant reduction of pain; nevertheless, in the group treated with US-hydrodilation, there was no need for re-treatment.
CONCLUSIONS: The US-guided hydrodilation for SACB should be the preferred technique to detach bursal walls and improve patient symptoms, since it requires fewer invasive maneuvers.
摘要：
目的：肩痛是导致患者接受医学评估的主要原因之一。今天,超声（US）是骨科医学中必不可少的工具，风湿病和康复设置，以解决肌肉骨骼疼痛的原因。肩部抱怨的最常见原因之一是频繁的肩峰下慢性滑囊炎（SACB）。在这种情况下,法氏囊壁的增厚以及随后两个滑膜片的融合导致法氏囊壁在肩峰下滑动的相互丧失，从而导致疼痛。这种情况是肩部疼痛的常见原因，肌肉骨骼超声医师可以很容易地解决。本文的目的是描述SACB的US外观，并评估US引导的加氢扩张在其治疗中的疗效。
方法：我们纳入了在我们的门诊就诊的肩部疼痛患者，这些患者的肩部抱怨诊断为法氏囊壁>1.5mm的SACB。一组通过US引导的加氢扩张治疗，而对照组则通过经典的盲法使用曲安奈德进行治疗。两组在注射后接受相同的康复计划。在基线时通过qDASH问卷评估肩部功能，第3、7、14、30、60和90天。P<0.05被认为是显著的。
结果：两组均显示疼痛明显减轻；尽管如此，在接受US-加氢扩张治疗的组中，没有必要再治疗。
结论：美国指导的SACB加氢扩张应该是分离法氏囊壁和改善患者症状的首选技术，因为它需要更少的侵入性操作。
方法：我们纳入了在我们的门诊就诊的肩部疼痛患者，这些患者的肩部抱怨诊断为法氏囊壁>1.5mm的SACB。一组通过US引导的加氢扩张治疗，而对照组则通过经典的盲法使用曲安奈德进行治疗。两组在注射后接受相同的康复计划。在基线时通过qDASH问卷评估肩部功能，第3、7、14、30、60和90天。P<0.05被认为是显著的。
结果：两组均显示疼痛明显减轻；尽管如此，在接受US-加氢扩张治疗的组中，没有必要再治疗。
结论：美国指导的SACB加氢扩张应该是分离法氏囊壁和改善患者症状的首选技术，因为它需要更少的侵入性操作。
