The spectrum of sonographic findings with radiographic correlation in patients with shoulder pain at kenyatta national hospital

Abstract

Background Shoulder pain is a common musculoskeletal presentation. Prevalence estimates vary from 6.9% to 26% in the general population. The most frequent cause of shoulder pain is rotator cuff disease. Shoulder radiography is often used in the initial evaluation of shoulder pain but is limited in the evaluation of the soft tissues. MRI with its excellent soft tissue characterization is the main modality used in the evaluation of shoulder soft tissues locally but is limited by cost and availability. Shoulder ultrasonography is a cheaper modality for evaluating the soft tissues with results comparable to MRI, but is underutilized locally. Objective This study was designed to determine the spectrum of shoulder sonographic and radiographic findings in patients with shoulder pain at Kenyatta National Hospital. Setting Department of Diagnostic Imaging and Radiation Medicine, University of Nairobi. It is located within the old wing of Kenyatta National Hospital. Study design This was a cross sectional descriptive study. Sample size A total of 72 patients with shoulder pain who were referred for shoulder radiographs and offered complementary ultrasound. Method The study was conducted over a period of six months between the months of November 2015 to April 2016. 72 patients referred for Shoulder radiographs had a complementary shoulder ultrasound scan done and findings of both examinations recorded in the data collection form. Statistical analysis of the findings was then done using SPSS version 20 IBM. Results Radiographs picked abnormalities in 36 (50%) patients majority of which were degenerative changes. Ultrasound picked abnormalities in 57(79%) patients with the bulk of lesions seen within the rotator cuff. There was a 58% marginal increase in diagnostic yield when ultrasound was used in series with radiographs. Conclusion The combination of shoulder radiography and ultrasound significantly increased the diagnostic yield by evaluating both osseous and soft tissue components. These findings aim to increase the awareness and utility of shoulder ultrasound locally.