Objective

To describe the number, specifics and co-occurrence of shoulder pathologies detected by MRI in manual wheelchair users with spinal cord injury and to evaluate the association between shoulder pathologies and presence of shoulder pain.

Design

Cross-sectional observation study.

Setting

Community.

Participants

Fifty-one wheelchair-dependent persons with spinal cord injury (44 males, 7 females, median age 50 years (IQR 14), median time since injury 24 years (IQR 16)) were allocated to pain or no-pain group based on the Wheelchair User Shoulder Pain Index.

Interventions

Not applicable

Outcome measures

All persons underwent shoulder MRI. Pathologies were scored blinded by two experienced radiologists. Participant characteristics, number and severity of shoulder pathologies were analyzed descriptively. Logistic regression was performed to evaluate the association between MRI findings and shoulder pain.

Results

The median number of co-occurring MRI findings per person ranged from 0 to 19 (out of 31 possible findings). The cluster of MRI findings occurring most often together were tendon tears of supraspinatus (present in 84%), subscapularis (69%) and biceps (67%) and osteoarthritis of acromioclavicular joint (80%). When correcting for age and time since injury, the logistic regression showed no statistically significant correlation between the individual pathologies and shoulder pain.

Conclusion

MRI findings of shoulder pathology are very frequent in persons with and without shoulder pain. Therefore, when diagnosing the cause of shoulder pain and planning interventions, health care professionals should keep this finding in mind and MRI should not be interpreted without careful consideration of clinical history and functional testing.

中文翻译：

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脊髓损伤轮椅使用者肩部病变的 MRI 评估及其与肩部疼痛的关系

客观的

描述在脊髓损伤的手动轮椅使用者中通过 MRI 检测到的肩部病变的数量、细节和共现，并评估肩部病变与肩部疼痛之间的关联。

设计

横断面观察研究。

环境

社区。

参加者

51 名依赖轮椅的脊髓损伤患者（44 名男性，7 名女性，中位年龄 50 岁（IQR 14），受伤后中位时间 24 年（IQR 16））被分配到疼痛组或无痛组轮椅使用者肩痛指数。

干预措施

不适用

结果措施

所有人都接受了肩部 MRI 检查。病理评分由两名经验丰富的放射科医师设盲。描述性分析了参与者特征、数量和肩部病变的严重程度。进行逻辑回归以评估 MRI 结果与肩痛之间的关联。

结果

每人同时出现的 MRI 检查结果的中位数在 0 到 19 之间（在 31 个可能的检查结果中）。最常同时出现的一组 MRI 结果是冈上肌（84%）、肩胛下肌（69%）和二头肌（67%）的肌腱撕裂，以及肩锁关节的骨关节炎（80%）。在校正年龄和受伤后的时间后，逻辑回归显示个体病理与肩痛之间没有统计学上的显着相关性。

结论

肩部病变的 MRI 结果在有或没有肩痛的人中非常常见。因此，在诊断肩痛的原因和规划干预措施时，医疗保健专业人员应牢记这一发现，并且在仔细考虑临床病史和功能测试的情况下不应解读 MRI。