Ultrasonographic and Physical Examination to Investigate the Cause of Painful Hemiplegic Shoulder

ABSTRACT

OBJECTIVE: To investigate the musculoskeletal cause of hemiplegic shoulder pain using ultrasonographic evaluation of hemiplegic shoulder. METHOD: Thirty-six hemiplegic patients admitted to rehabilitation department were enrolled. Ultrasonographic investigation of shoulder and physical examinations including range of motion (ROM), muscle power, spasticity and subluxation of shoulders were performed. RESULTS: Eighteen (55.6%) patients reported pain in hemiplegic shoulder. The abnormal sonographic findings, ROM, muscle power, spasticity, and subluxation of hemiplegic shoulder were not significantly different between subjects with painful hemiplegic shoulder and those without. The presence of ultrasonographic abnormality combined with focal tenderness, however, was significantly related with the painfulness of hemiplegic shoulder (p-value = 0.03). CONCLUSION: These results suggest that ultrasonographic evaluation is useful to investigate the musculoskeletal component of painful hemiplegic shoulder, when collaborated with physical examination of focal tenderness.