Comparison of Ultrasonographic Findings with Clinical Findings in Hemiplegic Shoulder

ABSTRACT

OBJECTIVE: To identify the etiology of hemiplegic shoulder pain by ultrasonographic and clinical examinations and to determine the correlation between ultrasonographic findings and clinical factors in patients with hemiplegic shoulder. METHOD: Seventy hemiplegic patients with shoulder pain or without shoulder pain were enrolled. All of patients were evaluated by ultrasonography. We analyzed clinical factors including visual analogue scale (VAS) of hemiplegic shoulder pain, shoulder subluxation measured by plain X-ray, shoulder manual muscle test (MMT), passive range of motion (PROM) of the shoulder joint and complex regional pain syndrome (CRPS). RESULTS: 51.0% of patients with shoulder pain showed abnormal ultrasonographic findings, while 9.5% of patients without shoulder pain. Those with abnormal ultrasonographic findings had significantly decreased shoulder PROM in flexion, abduction, external rotation and internal rotation and more severe subluxation of hemiplegic shoulder (p<0.05). CONCLUSION: After investigating the hemiplegic shoulder through ultrasonography, painful hemiplegic shouder had high incidence of abnormal ultrasonographic characteristics. Ultrasonography is more worthwhile and useful as an primary diagnostic method, especially when there is severe shoulder subluxation and the limitation of PROM of shoulder in hemiplegic patients.