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Detection of Subacromial Bursa Thickening by Sonography in Shoulder Impingement Syndrome

Author(s): Yao-Hung Tsai | Tsung-Jen Huang | Wei-Hsiu Hsu | Kuo-Chin Huang | Yen-Yao Li | Kuo-Ti Peng | Robert Wen-Wei Hsu

Journal: Chang Gung Medical Journal
ISSN 2072-0939

Volume: 30;
Issue: 02;
Start page: 135;
Date: 2007;
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Keywords: ultrasonography | subacromial-subdeltoid bursa | impingement | rotator cuff

Background: Normally, the subacromial-subdeltoid bursa is thinner than 2 mm using ultrasoundexamination. The subtle thickening of the bursa could be an early signof subacromial impingement and possibly a rotator cuff tear. The aim of thisstudy was to compare the thickness of subacromial bursa measured usingultrasonography in the painful shoulder with normal side, and also to differentiateNeer stages I and II impingements in patients with unilateral shoulderpain.Methods: We performed bilateral shoulder sonography in 268 consecutive patients withunilateral shoulder pain and clinical suggestion of rotator cuff pathology. Thestudy group consisted of 102 cases of Neer stage I and 166 cases of Neerstage II impingement syndrome. The bursa thickness was calculated from thesuperficial peribursal fat to the upper margin of the supraspinatus.Results: A statistically significant association was detected (p < .0001) between thesymptomatic shoulder and asymptomatic side (mean thickness, 1.27mm/0.75 mm). The thickness of bursa in patients with Neer stage I impingementhad no statistically important link the results of the patients with Neerstage II impingement.Conclusion: Increased bursa thickness in the symptomatic side may be an alternativesonographic indicator of subacromial bursitis and partial-thickness rotatorcuff tears, even when measured to be less than 2 mm. Sonographic examinationof subacromial bursa thickness is not an appropriate technique to differentiatethe Neer stages I and II impingement. Further study is needed toquantify the echogenicity of the supraspinatus tendon and to show a level ofaccuracy in patients with rotator cuff tendinosis or partial tears.
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