Generic placeholder image

Current Medical Imaging

Editor-in-Chief

ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

Review Article

Ultrasound-guided Treatments for the Painful Shoulder

Author(s): Nicolas Papalexis, Federico Ponti, Raffaella Rinaldi, Giuliano Peta, Riccardo Bruno, Marco Miceli, Milva Battaglia, Alessandro Marinelli and Paolo Spinnato*

Volume 18, Issue 7, 2022

Published on: 14 February, 2022

Article ID: e061221198582 Pages: 8

DOI: 10.2174/1573405617666211206112752

Price: $65

Abstract

Shoulder pain is an extremely common condition. The painful shoulder may be the result of a wide spectrum of underlying pathological conditions, including calcific tendinopathy of the rotator cuff, subacromial-subdeltoid bursitis, acromioclavicular or glenohumeral arthritis, tenosynovitis of the long biceps tendon, rotator cuff lesions, and many other less common conditions. Ultrasound imaging is an effective tool for the diagnosis and also for the image guidance of treatment of the majority of these conditions. Several ultrasound-guided procedures are effective for pain relief, such as percutaneous irrigation, intra-bursal or intra-articular drugs injection, fluid aspiration, neural block. This review article aims to summarize and discuss the most common treatment possibilities with ultrasound guidance for the painful shoulder.

Keywords: Ultrasonography, interventional, tendinopathy, shoulder pain, shoulder joint, arthritis, bursitis, injections, intra-articular, radiology.

Graphical Abstract
[1]
Messina C, Banfi G, Orlandi D, et al. Ultrasound-guided interventional procedures around the shoulder. Br J Radiol 2016; 89(1057): 20150372.
[http://dx.doi.org/10.1259/bjr.20150372] [PMID: 26313499]
[2]
Huygen F, Patijn J, Rohof O, et al. 9. Painful shoulder complaints. Pain Pract 2010; 10(4): 318-26.
[http://dx.doi.org/10.1111/j.1533-2500.2010.00389.x] [PMID: 20456651]
[3]
Andrews JR. Diagnosis and treatment of chronic painful shoulder: Review of nonsurgical interventions. Arthroscopy 2005; 21(3): 333-47.
[http://dx.doi.org/10.1016/j.arthro.2004.11.003] [PMID: 15756189]
[4]
ElShewy MT. Calcific tendinitis of the rotator cuff. World J Orthop 2016; 7(1): 55-60.
[http://dx.doi.org/10.5312/wjo.v7.i1.55] [PMID: 26807357]
[5]
Bloom JE, Rischin A, Johnston RV, Buchbinder R. Image-guided versus blind glucocorticoid injection for shoulder pain. Cochrane Database Syst Rev 2012; (8): CD009147.
[http://dx.doi.org/10.1002/14651858.CD009147.pub2] [PMID: 22895984]
[6]
Cho CH, Min BW, Bae KC, Lee KJ, Kim DH. A prospective double-blind randomized trial on ultrasound-guided versus blind intra-articular corticosteroid injections for primary frozen shoulder. Bone Joint J 2021; 103-B(2): 353-9.
[http://dx.doi.org/10.1302/0301-620X.103B2.BJJ-2020-0755.R1] [PMID: 33517741]
[7]
Sconfienza LM, Adriaensen M, Albano D, et al. Clinical indications for image-guided interventional procedures in the musculoskeletal system: A Delphi-based consensus paper from the European Society of Musculoskeletal Radiology (ESSR)-part I, shoulder. Eur Radiol 2020; 30(2): 903-13.
[http://dx.doi.org/10.1007/s00330-019-06419-x] [PMID: 31529252]
[8]
Amber KT, Landy DC, Amber I, Knopf D, Guerra J. Comparing the accuracy of ultrasound versus fluoroscopy in glenohumeral injections: A systematic review and meta-analysis. J Clin Ultrasound 2014; 42(7): 411-6.
[http://dx.doi.org/10.1002/jcu.22154] [PMID: 24668738]
[9]
Aly AR, Rajasekaran S, Ashworth N. Ultrasound-guided shoulder girdle injections are more accurate and more effective than landmark-guided injections: A systematic review and meta-analysis. Br J Sports Med 2015; 49(16): 1042-9.
[http://dx.doi.org/10.1136/bjsports-2014-093573] [PMID: 25403682]
[10]
Bot SD, van der Waal JM, Terwee CB, et al. Incidence and prevalence of complaints of the neck and upper extremity in general practice. Ann Rheum Dis 2005; 64(1): 118-23.
[http://dx.doi.org/10.1136/ard.2003.019349] [PMID: 15608309]
[11]
Feleus A, Bierma-Zeinstra SM, Miedema HS, Bernsen RM, Verhaar JA, Koes BW. Incidence of non-traumatic complaints of arm, neck and shoulder in general practice. Man Ther 2008; 13(5): 426-33.
[http://dx.doi.org/10.1016/j.math.2007.05.010] [PMID: 17681866]
[12]
Linsell L, Dawson J, Zondervan K, et al. Prevalence and incidence of adults consulting for shoulder conditions in UK primary care; patterns of diagnosis and referral. Rheumatology (Oxford) 2006; 45(2): 215-21.
[http://dx.doi.org/10.1093/rheumatology/kei139] [PMID: 16263781]
[13]
van der Windt DA, Koes BW, de Jong BA, Bouter LM. Shoulder disorders in general practice: Incidence, patient characteristics, and management. Ann Rheum Dis 1995; 54(12): 959-64.
[http://dx.doi.org/10.1136/ard.54.12.959] [PMID: 8546527]
[14]
Greving K, Dorrestijn O, Winters JC, et al. Incidence, prevalence, and consultation rates of shoulder complaints in general practice. Scand J Rheumatol 2012; 41(2): 150-5.
[http://dx.doi.org/10.3109/03009742.2011.605390] [PMID: 21936616]
[15]
Picavet HS, Schouten JS. Musculoskeletal pain in the Netherlands: Prevalences, consequences and risk groups, the DMC(3)-study. Pain 2003; 102(1-2): 167-78.
[http://dx.doi.org/10.1016/s0304-3959(02)00372-x] [PMID: 12620608]
[16]
Luime JJ, Koes BW, Hendriksen IJ, et al. Prevalence and incidence of shoulder pain in the general population; a systematic review. Scand J Rheumatol 2004; 33(2): 73-81.
[http://dx.doi.org/10.1080/03009740310004667] [PMID: 15163107]
[17]
Urwin M, Symmons D, Allison T, et al. Estimating the burden of musculoskeletal disorders in the community: The comparative prevalence of symptoms at different anatomical sites, and the relation to social deprivation. Ann Rheum Dis 1998; 57(11): 649-55.
[http://dx.doi.org/10.1136/ard.57.11.649] [PMID: 9924205]
[18]
Meislin RJ, Sperling JW, Stitik TP. Persistent shoulder pain: Epidemiology, pathophysiology, and diagnosis. Am J Orthop 2005; 34(12)(Suppl.): 5-9.
[PMID: 16450690]
[19]
Chianca V, Albano D, Messina C, et al. Rotator cuff calcific tendinopathy: From diagnosis to treatment. Acta Biomed 2018; 89(1): 186-96.
[http://dx.doi.org/10.23750/abm.v89i1-S.7022]
[20]
Katz WA. Musculoskeletal pain and its socioeconomic implications. Clin Rheumatol 2002; 21(Suppl. 1): S2-4.
[http://dx.doi.org/10.1007/s100670200028] [PMID: 11954899]
[21]
Uhthoff HK, Sarkar K. Calcifying tendinitis. Baillieres Clin Rheumatol 1989; 3(3): 567-81.
[http://dx.doi.org/10.1016/S0950-3579(89)80009-3] [PMID: 2624948]
[22]
Tagliafico A, Russo G, Boccalini S, et al. Ultrasound-guided interventional procedures around the shoulder. Radiol Med (Torino) 2014; 119(5): 318-26.
[http://dx.doi.org/10.1007/s11547-013-0351-2] [PMID: 24297588]
[23]
Faruqi T, Rizvi TJ. Subacromial Bursitis. In: StatPearls. Treasure Island (FL): StatPearls Publishing 2020.
[24]
Aaron DL. Four common types of bursitis: Diagnosis and management. J Am Acad Orthop Surg 2011; 19(6): 359-67.
[25]
Awerbuch MS. The clinical utility of ultrasonography for rotator cuff disease, shoulder impingement syndrome and subacromial bursitis. Med J Aust 2008; 188(1): 50-3.
[http://dx.doi.org/10.5694/j.1326-5377.2008.tb01507.x] [PMID: 18205566]
[26]
Macías-Hernández SI, Morones-Alba JD, Miranda-Duarte A, et al. Glenohumeral osteoarthritis: Overview, therapy, and rehabilitation. Disabil Rehabil 2017; 39(16): 1674-82.
[http://dx.doi.org/10.1080/09638288.2016.1207206] [PMID: 27416338]
[27]
Saltzman BM. Glenohumeral osteoarthritis in the young patient. J Am Acad Orthop Surg 2018; 26(17): 361-70.
[http://dx.doi.org/10.5435/JAAOS-D-16-00657]
[28]
Burbank KM, Stevenson JH, Czarnecki GR, Dorfman J. Chronic shoulder pain: Part I. Evaluation and diagnosis. Am Fam Physician 2008; 77(4): 453-60.
[PMID: 18326164]
[29]
Raynor MB, Kuhn JE. Utility of features of the patient’s history in the diagnosis of atraumatic shoulder pain: A systematic review. J Shoulder Elbow Surg 2016; 25(4): 688-94.
[http://dx.doi.org/10.1016/j.jse.2015.09.023] [PMID: 26711472]
[30]
Sethi N, Wright R, Yamaguchi K. Disorders of the long head of the biceps tendon. J Shoulder Elbow Surg 1999; 8(6): 644-54.
[http://dx.doi.org/10.1016/S1058-2746(99)90105-2] [PMID: 10633904]
[31]
Bicipital Tenosynovitis. Clinical Orthopaedics 2001; 18: 261-8.
[32]
Patton WC, McCluskey GM III. Biceps tendinitis and subluxation. Clin Sports Med 2001; 20(3): 505-29.
[http://dx.doi.org/10.1016/S0278-5919(05)70266-0] [PMID: 11494838]
[33]
Middleton WD, Reinus WR, Totty WG, Melson GL, Murphy WA. US of the biceps tendon apparatus. Radiology 1985; 157(1): 211-5.
[http://dx.doi.org/10.1148/radiology.157.1.3898217] [PMID: 3898217]
[34]
Lanza E, Piccoli F, Intrieri C, et al. US-guided percutaneous irrigation of calcific tendinopathy of the rotator cuff in patients with or without previous external shockwave therapy. Radiol Med (Torino) 2021; 126(1): 117-23.
[http://dx.doi.org/10.1007/s11547-020-01229-4] [PMID: 32451885]
[35]
Serafini G, Sconfienza LM, Lacelli F, Silvestri E, Aliprandi A, Sardanelli F. Rotator cuff calcific tendonitis: Short-term and 10-year outcomes after two-needle us-guided percutaneous treatment- nonrandomized controlled trial. Radiology 2009; 252(1): 157-64.
[http://dx.doi.org/10.1148/radiol.2521081816] [PMID: 19561254]
[36]
Pagnini F, D'Amuri FV, Bevilacqua A, et al. Ultrasound-guided percutaneous irrigation of calcific tendinopathy: Technical developments. Acta Biomed 2019; 90(5): 95-100.
[http://dx.doi.org/10.23750/abm.v90i5-S.8333]
[37]
Messina C, Sconfienza LM. Ultrasound-guided percutaneous irrigation of calcific tendinopathy. Semin Musculoskelet Radiol 2016; 20(5): 409-13.
[http://dx.doi.org/10.1055/s-0036-1594285] [PMID: 28002862]
[38]
Pasquotti G, Faccinetto A, Marchioro U, et al. US-guided percutaneous treatment and physical therapy in rotator cuff calcific tendinopathy of the shoulder: Outcome at 3 and 12 months. Eur Radiol 2016; 26(8): 2819-27.
[http://dx.doi.org/10.1007/s00330-015-4102-8] [PMID: 26694061]
[39]
de Witte PB, Selten JW, Navas A, et al. Calcific tendinitis of the rotator cuff: A randomized controlled trial of ultrasound-guided needling and lavage versus subacromial corticosteroids. Am J Sports Med 2013; 41(7): 1665-73.
[http://dx.doi.org/10.1177/0363546513487066] [PMID: 23696211]
[40]
Robinson CM, Seah KT, Chee YH, Hindle P, Murray IR. Frozen shoulder. J Bone Joint Surg Br 2012; 94(1): 1-9.
[http://dx.doi.org/10.1302/0301-620X.94B1.27093] [PMID: 22219239]
[41]
Uppal HS, Evans JP, Smith C. Frozen shoulder: A systematic review of therapeutic options. World J Orthop 2015; 6(2): 263-8.
[http://dx.doi.org/10.5312/wjo.v6.i2.263] [PMID: 25793166]
[42]
Buchbinder R, Green S, Youd JM. Corticosteroid injections for shoulder pain. Cochrane Database Syst Rev 2003; 2003(1): CD004016.
[http://dx.doi.org/10.1002/14651858.CD004016] [PMID: 12535501]
[43]
Zuckerman JD, Cuomo F. Frozen shoulder. In: Matsen FA, III, Fu FH, Hawkins RJ, Eds. The Shoulder: A balance of Mobility and Stability. Rosemont: American Academy of Orthopedic Surgery 1993; pp. 99-109.
[44]
Bryant M, Gough A, Selfe J, Richards J, Burgess E. The effectiveness of ultrasound guided hydrodistension and physiotherapy in the treatment of frozen shoulder/adhesive capsulitis in primary care: A single centre service evaluation. Shoulder Elbow 2017; 9(4): 292-8.
[http://dx.doi.org/10.1177/1758573217701063] [PMID: 28932287]
[45]
Buchbinder R, Green S, Forbes A, Hall S, Lawler G. Arthrographic joint distension with saline and steroid improves function and reduces pain in patients with painful stiff shoulder: Results of a randomised, double blind, placebo controlled trial. Ann Rheum Dis 2004; 63(3): 302-9.
[http://dx.doi.org/10.1136/ard.2002.004655] [PMID: 14962967]
[46]
Koh KH. Corticosteroid injection for adhesive capsulitis in primary care: A systematic review of randomised clinical trials. Singapore Med J 2016; 57(12): 646-57.
[http://dx.doi.org/10.11622/smedj.2016146] [PMID: 27570870]
[47]
Tagliafico A, Serafini G, Sconfienza LM, et al. Ultrasound-guided viscosupplementation of subacromial space in elderly patients with cuff tear arthropathy using a high weight hyaluronic acid: Prospective open-label non-randomized trial. Eur Radiol 2011; 21(1): 182-7.
[http://dx.doi.org/10.1007/s00330-010-1894-4] [PMID: 20658295]
[48]
Pourcho AM, Colio SW, Hall MM. Ultrasound-guided interventional procedures about the shoulder: Anatomy, indications, and techniques. Phys Med Rehabil Clin N Am 2016; 27(3): 555-72.
[http://dx.doi.org/10.1016/j.pmr.2016.04.001] [PMID: 27468666]
[49]
Fessell D, Holsbeeck M. Ultrasound guided musculoskeletal procedures. Ultrasound Clin 2007; 2(2): 737-57.
[50]
Hansford BG, Stacy GS. Musculoskeletal aspiration procedures. Semin Intervent Radiol 2012; 29(4): 270-85.
[http://dx.doi.org/10.1055/s-0032-1330061] [PMID: 24293800]
[51]
Fernandes MR, Barbosa MA, Sousa AL, Ramos GC. Suprascapular nerve block: Important procedure in clinical practice. Rev Bras Anestesiol 2012; 62(1): 96-104.
[http://dx.doi.org/10.1016/S0034-7094(12)70108-3] [PMID: 22248771]
[52]
Joshi G, Gandhi K, Shah N, Gadsden J, Corman SL. Peripheral nerve blocks in the management of postoperative pain: Challenges and opportunities. J Clin Anesth 2016; 35: 524-9.
[http://dx.doi.org/10.1016/j.jclinane.2016.08.041] [PMID: 27871587]
[53]
Peng PW, Cheng P. Ultrasound-guided interventional procedures in pain medicine: A review of anatomy, sonoanatomy, and procedures. Part III: Shoulder. Reg Anesth Pain Med 2011; 36(6): 592-605.
[http://dx.doi.org/10.1097/AAP.0b013e318231e068] [PMID: 22005657]
[54]
Chan CW, Peng PW. Suprascapular nerve block: a narrative review. Reg Anesth Pain Med 2011; 36(4): 358-73.
[http://dx.doi.org/10.1097/AAP.0b013e3182204ec0] [PMID: 21654552]
[55]
Chang KV, Hung CY, Wu WT, Han DS, Yang RS, Lin CP. Comparison of the effectiveness of suprascapular nerve block with physical therapy, placebo, and intra-articular injection in management of chronic shoulder pain: A meta-analysis of randomized controlled Trials. Arch Phys Med Rehabil 2016; 97(8): 1366-80.
[http://dx.doi.org/10.1016/j.apmr.2015.11.009] [PMID: 26701762]
[56]
Strakowski JA. Ultrasound-guided peripheral nerve procedures. Phys Med Rehabil Clin N Am 2016; 27(3): 687-715.
[http://dx.doi.org/10.1016/j.pmr.2016.04.006] [PMID: 27468673]
[57]
Hewson DW, Bedforth NM, Hardman JG. Peripheral nerve injury arising in anaesthesia practice. Anaesthesia 2018; 73(Suppl. 1): 51-60.
[http://dx.doi.org/10.1111/anae.14140] [PMID: 29313904]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy