MRI evaluation of painful hemiplegic shoulder in patients after stroke: A pilot study

Abstract

Objective To observe the structural abnormalities of the painful shoulder in patients soon after stroke by M RI,and to identify the possible causes of post-stroke shoulder pain (PSSP).Methods Patients with hemiplegia following their first cerebrovascular accident were divided into 2 groups:PSSP group (32 patients) and post-stroke no shoulder pain (PSNSP) group (20 patients).Physical findings of affected shoulder and MRI findings of both affected and unaffected shoulders were evaluated.Results Shoulder subluxation was significantly more frequent in PSSP group than in PSNSP group (53％ vs 15％,P ＜0.05).In PSSP group,the incidence rate of rotator cuff injury,subacromial-subdeltoid bursa effusion,glenohumeral joint effusion,effusion of long head of biceps tendon was higher in affected side than that in unaffected side(63％ vs 13％,53％ vs 13％,75％ vs 31％,41％ vs 13％,respectively).In PSNSP group,the incidence rate of glenohumeral joint effusion was higher in affected side than that in unaffected side (70％ vs 17％).But compared with no pain hemiplegic shoulder,only rotator cuff injury and subacromial-subdeltoid bursa effusion were significantly higher in PSSP patients (63％ vs15％,53％ vs 25％,respectively),and there was significant difference between the two groups (P ＜0.05).Conclusion Rotator cuff injury was found to be a possible cause of PSSP. Key words: Poststroke shoulder pain; Stroke; MRI