Usefulness of Ultrasonographic Examination in Diagnosis and Follow-up of the Frozen Shoulder

동결견의 진단과 치료 경과 판정에 대한 초음파 검사의 유용성

  • Choi, Chang-Hyuk (Shoulder & Elbow joint Service, Department of Orthopaedic Surgery, Daegu Catholic University Medical Center) ;
  • Kim, Seok-Jun (Shoulder & Elbow joint Service, Department of Orthopaedic Surgery, Daegu Catholic University Medical Center) ;
  • Lee, Sang-Hwa (Shoulder & Elbow joint Service, Department of Orthopaedic Surgery, Daegu Catholic University Medical Center) ;
  • Kim, Hee-Soo (Shoulder & Elbow joint Service, Department of Orthopaedic Surgery, Daegu Catholic University Medical Center) ;
  • Shim, Jung-Hyun (Shoulder & Elbow joint Service, Department of Orthopaedic Surgery, Daegu Catholic University Medical Center)
  • 최창혁 (대구가톨릭대학교 의과대학 정형외과학교실) ;
  • 김석준 (대구가톨릭대학교 의과대학 정형외과학교실) ;
  • 이상화 (대구가톨릭대학교 의과대학 정형외과학교실) ;
  • 김희수 (대구가톨릭대학교 의과대학 정형외과학교실) ;
  • 심정현 (대구가톨릭대학교 의과대학 정형외과학교실)
  • Published : 2014.03.31

Abstract

Purpose: In order to know the effectiveness of ultrasonographic examination in diagnosis and follow-up evaluation for the frozen shoulder, we compared those with contralateral side in initial and after steroid injection. Materials and Methods: For the 20 unilateral frozen shoulder from July 2012 to July 2013, ultrasonographic examination was tried using reference line 1 (CBT: distance from coracoid process to LHB tendon) and line 2 (CBG: distance from coracoid process to bicipital groove). We tried 1 time steroid injection and compared the improvement in gross motion and reference line with 2 month, 4 month, and 6 month's serial ultrasonographic examination. Results: The differences on CBT line between lesion side and normal side were -5.6 mm, -5.0 mm, and -4.3 mm in neutral (Neut), external rotation (ER) and internal rotation (IR), respectively. The differences on CBG line were -6.1 mm, -4.7 mm, and -5.0 mm respectively (p<0.05). The changes in the reference line after steroid injection were evaluated at 2 month (CBT: -4.8 mm, -3.5 mm, -2.6 mm / CBG: -4.7 mm, -4.0 mm, -3.6 mm), 4 month (CBT: -4.7 mm, -3.2 mm, -1.7 mm / CBG: -4.3 mm, -3.7 mm, -1.2 mm), and 6 month (CBT: -1.1 mm, -2.9 mm, -0.5 mm / CBG: -1.2 mm, -0.7 mm, -0.9 mm). The gross motion was improved at 4 month after injection, from elevation $108^{\circ}$, ER $32^{\circ}$, IR L5 in initial to $133^{\circ}$, $42^{\circ}$, L3 respectively (p<0.05). Pain improved from 7.5 in initial to 3.0 at 2 month on visual analog scale (VAS). Conclusion: The serial examination after steroid injection revealed that the delayed improvement on reference line (6 month) compared with pain (2 month) or gross motion (4 month). Dynamic ultrasonogram was useful in diagnosis and follow-up evaluation of frozen shoulder.