ABSTRACT
We examined uptake of 2-[(18)F]-fluoro-2-deoxy-D-glucose (FDG) using positron emission tomography (PET) into the bilateral shoulder muscles of four patients before and after unilateral rotator cuff repair. The relative ratio of the subtracted standardized uptake value on the supraspinatus with a torn supraspinatus tendon to that of the subscapularis on the ipsilateral side was significantly lower than that on the normal side (0.69 +/- 0.05 versus 1.06 +/- 0.36). The relative ratio of the infraspinatus on the rupture side was also significantly lower than that on the normal side (0.91 +/- 0.09 versus 1.41 +/- 0.35). However, by 6 months postoperative, the reduced glucose metabolism in these muscles had recovered to the same levels as those on the normal side. As indicated by FDG PET, muscle metabolism in rotator cuff tears was reduced, subsequently recovering to the level of the normal side after operative repair.
Subject(s)
Fluorodeoxyglucose F18 , Orthopedic Procedures , Positron-Emission Tomography , Radiopharmaceuticals , Rotator Cuff Injuries , Rotator Cuff/diagnostic imaging , Aged , Fluorodeoxyglucose F18/metabolism , Humans , Injury Severity Score , Japan , Magnetic Resonance Imaging , Male , Middle Aged , Postoperative Period , Radiopharmaceuticals/metabolism , Recovery of Function , Rotator Cuff/metabolism , Rotator Cuff/pathology , Rotator Cuff/surgery , Rupture/diagnostic imaging , Shoulder/diagnostic imaging , Shoulder Injuries , Treatment OutcomeABSTRACT
The uptake of 2-[(18)F]-fluoro-2-deoxy-d-glucose (FDG) into shoulder muscles was studied in 11 patients with rotator cuff tears. FDG was injected under resting conditions, and cuff muscle exercises were performed followed by evaluation of the standardized uptake value (SUV) in shoulder muscles bilaterally. Analysis was performed with a subtracted SUV, obtained by subtracting the SUV of the muscle at rest from that after exercise. Fusion imaging studies involving FDG positron emission tomography (PET) and magnetic resonance imaging would provide a novel strategy with the potential of improving on the limited resolution of PET images. In this study this relatively new strategy revealed a similar decrease in the supraspinatus SUV in cases involving both complete and partial tears. The SUV in the infraspinatus and subscapularis also decreased, regardless of whether these muscles were intact or ruptured; the SUV in the deltoid remained basically unchanged. With the use of this exercise protocol, FDG PET might prove useful for objective evaluation of rotator cuff muscle activity.
Subject(s)
Fluorodeoxyglucose F18 , Radiopharmaceuticals , Rotator Cuff Injuries , Rotator Cuff/metabolism , Tomography, Emission-Computed , Aged , Female , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Rotator Cuff/pathology , RuptureABSTRACT
It is known that hyaluronic acid can protect against damage to articular cartilage and helps to lessen friction between joint surfaces. Furthermore, it is reported that hyaluronic acid is effective for pain relief and for the risk of adhesion, and contractures of joints. The injection of hyaluronic acid is useful for the treatment of frozen shoulder, osteoarthritis, and rheumatoid arthritis. The risk of infection is a rare, though important, possibility, however this method is relatively safe.
