【論文摘要】Ultrasonographic Evaluation of Coracohumeral Ligament Thickness and Coracohumeral Distance in Shoulder Impingement Syndrome With and Without Subscapularis Lesion

【論文摘要】有無肩胛下肌損傷之肩夾擠症候群患者於喙肱韌帶厚度與喙肱距離的超音波影像量測

張哲源(Che-Yuan Chang) ； 陳登翔(Deng-Siang Ting) ； 林居正(Jiu-Jenq Lin)

《物理治療》 47卷2期 (2022/06) Pp. 108-109

https://doi.org/10.6215/FJPT.202206.O03

摘要

Background and Purpose: Subacromial and subcoracoid impingement have been categorized as external impingement of the shoulder impingement syndrome (SIS). Differentiation between subacromial impingement versus subcoracoid impingement is important for the treatment target. The thickness of coracohumeral ligament (CHL) may affect coracohumeral distance (CHD), which has been suggested as a possible factor of developing subcoracoid impingement with subscapularis (SSC) lesion. Evidence that indicates the existence of abnormal SSC, CHL thickness, and CHD in people with SIS is limited. The purposes of the study were (1) to evaluate the correlations between the CHL thickness and CHD by using ultrasonography (USG) in SIS people with and without SSC lesion; (2) to examine the difference in SSC, CHL thickness, and CHD between SIS people with and without SSC lesion. Methods: This cross-sectional observational study analyzed 20 SIS subjects with SSC lesion and 20 no-SSC lesion people based on the clinical SSC tests. The participants were assessed for CHL thickness and CHD in 4 different shoulder positions by USG. Correlations between CHL thickness and CHD were calculated. Independent t-tests were tested on the outcome measurements between 2 groups. Results: Moderate correlations between CHL thickness with CHD (r = 0.455 in neutral position, p = 0.044; r = 0.483 in internal rotation, p = 0.031) were found in no-SSC lesion group. SSC lesion group showed greater CHL thickness (difference = 0.3 mm, effect size = 0.85, p = 0.006), SSC tendon thickness (difference = 0.7 mm, effect size = 0.92, p = 0.01) and SSC/CHD occupation ratio (difference = 8%, effect size = 0.95, p = 0.005) compared with no-SSC lesion group. Conclusions: The consistent increase of CHL thickness and CHD plays an important role in SIS patients without SSC lesion. CHL, SSC thickness, as well as SSC/CHD occupation ratio are important to consider in the rehabilitation of SIS patients with SSC lesion. Clinical Relevance: For patients with SIS, CHL thickness, CHD, SSC thickness, and SSC/CHD occupation ratio by USG may be used for outcome evaluation and progression.