ABSTRACT
Antecedentes y objetivo: La lesión del labrum superior anteroposterior (SLAP) es una conocida causa de dolor y disfunción del hombro en pacientes activos. El objetivo fue estudiar las lesiones de SLAP en población laboral y valorar la fiabilidad de la exploración física y las técnicas de imagen en el diagnóstico de las lesiones de SLAP en el entorno laboral. Material y métodos: Revisión retrospectiva de 58 lesiones de SLAP tratadas en nuestra mutua laboral desde 2005 hasta 2015 en 815 pacientes en los que se realizó una artroscopia de hombro. Se han recogido datos del mecanismo lesional, datos clínicos, pruebas complementarias (comparando el informe radiológico inicial con el de un radiólogo especializado en musculoesquelético), hallazgos artroscópicos y tratamiento realizado. Resultados: El mecanismo lesional más frecuente ha sido la lesión aguda levantando peso, en la mayoría de casos, por encima de la cabeza. La lesión de SLAP se sospechó en el 41% con anamnesis y exploración física, en el 29% de los informes radiológicos iniciales y en el 52% en los informes del radiólogo especialista en musculoesquelético. Presentaron lesiones asociadas el 78%, la mayoría lesiones del manguito rotador. Conclusión: La lesión de SLAP en el entorno laboral es infrecuente y muchas veces se diagnostica durante una artroscopia realizada por otra lesión. La artrorresonancia magnética y la resonancia magnética tienen menos fiabilidad que la evaluación clínica para su diagnóstico. Un radiólogo especializado en musculoesquelético podría mejorar la rentabilidad de las pruebas de imagen en el diagnóstico de estas lesiones
Background and objective: Superior labral anterior to posterior (SLAP) injuries are widely recognised as a cause of pain and dysfunction in the shoulders of active patients. The aims of the present study were to analyze SLAP injuries in the workplace, and to evaluate the reliability of physical examination and imaging techniques for the diagnosis of work-related SLAP injuries. Material and methods: Retrospective chart review of 58 SLAP injuries treated in our occupational health centre from 2005 to 2015 in 815 patients undergoing shoulder arthroscopy. Data were collected on mechanism of injury, clinical proceedings, complementary tests (contrasting the initial magnetic resonance imaging report with that of a radiologist specializing in musculoskeletal pathology), arthroscopy findings and treatments performed. Results: The most common mechanism of injury was acute injury while handling weight, in the majority of cases, above the head. SLAP injury was suspected in 41% of cases through anamnesis and physical exam, in 29% through the initial magnetic resonance imaging report, and in 52% through the specialised radiologist's report. In 78%, associated injuries were present, the most common being rotator cuff injuries. Conclusions: SLAP injuries in the workplace are rare and are often a diagnostic finding during surgical intervention performed for a different associated injury. Arthro-magnetic resonance imaging and magnetic resonance imaging have lower reliability than physical exams in the diagnosis of work-related SLAP injuries. A radiologist specializing in musculoskeletal pathology could probably improve the reliability of imaging test interpretation in work-related SLAP injuries
Subject(s)
Humans , Male , Female , Young Adult , Adult , Middle Aged , Lifting/adverse effects , Occupational Injuries/etiology , Shoulder Joint/injuries , Shoulder Pain/etiology , Arthroscopy/methods , Magnetic Resonance Imaging , Occupational Injuries/diagnostic imaging , Physical Examination , Retrospective Studies , Shoulder Joint/diagnostic imaging , Shoulder Pain/diagnostic imagingABSTRACT
BACKGROUND AND OBJECTIVE: Superior labral anterior to posterior (SLAP) injuries are widely recognised as a cause of pain and dysfunction in the shoulders of active patients. The aims of the present study were to analyze SLAP injuries in the workplace, and to evaluate the reliability of physical examination and imaging techniques for the diagnosis of work-related SLAP injuries. MATERIAL AND METHODS: Retrospective chart review of 58 SLAP injuries treated in our occupational health centre from 2005 to 2015 in 815 patients undergoing shoulder arthroscopy. Data were collected on mechanism of injury, clinical proceedings, complementary tests (contrasting the initial magnetic resonance imaging report with that of a radiologist specializing in musculoskeletal pathology), arthroscopy findings and treatments performed. RESULTS: The most common mechanism of injury was acute injury while handling weight, in the majority of cases, above the head. SLAP injury was suspected in 41% of cases through anamnesis and physical exam, in 29% through the initial magnetic resonance imaging report, and in 52% through the specialised radiologist's report. In 78%, associated injuries were present, the most common being rotator cuff injuries. CONCLUSIONS: SLAP injuries in the workplace are rare and are often a diagnostic finding during surgical intervention performed for a different associated injury. Arthro-magnetic resonance imaging and magnetic resonance imaging have lower reliability than physical exams in the diagnosis of work-related SLAP injuries. A radiologist specializing in musculoskeletal pathology could probably improve the reliability of imaging test interpretation in work-related SLAP injuries.
