Supraspinatus Tendinopathy Research Articles

Investigating the mechanism of supraspinatus tendinopathy induced by type 2 diabetes mellitus in rats using untargeted metabolomics analysis

Investigating the mechanism of supraspinatus tendinopathy induced by type 2 diabetes mellitus in rats using untargeted metabolomics analysis

Rotator Cuff Muscle-Tendon Properties Are Heterogeneously Affected By Exercise In Young Swimmers With Supraspinatus Tendinopathy

Rotator Cuff Muscle-Tendon Properties Are Heterogeneously Affected By Exercise In Young Swimmers With Supraspinatus Tendinopathy

Subacromial injection of platelet-rich plasma provides greater improvement in pain and functional outcomes compared to corticosteroids at 1-year follow-up: a double-blinded randomized controlled trial

BackgroundStudies evaluating the results of platelet-rich plasma (PRP) for the treatment of rotator cuff tendinopathy (RCT) have demonstrated conflicting results and have been confounded by small patient samples, the absence of a control group, the combined analysis of isolated tendinopathies and rotator cuff tears, insufficient reporting of PRP preparations, The purpose of this study was to perform a randomized controlled trial comparing platelet-rich plasma (PRP) with standard corticosteroid (CS) injections in providing pain relief and improved function in patients with rotator cuff tendinopathy. MethodsThis was a double-blind RCT at a single center. We evaluated patients between 18 and 50 years old who had both a clinical and magnetic resonance (MRI) diagnosis of supraspinatus tendinopathy refractory to conservative treatment. A total of 50 patients received PRP treatment, whereas 50 patients received a corticosteroid, as a control group. Patients completed patient-reported outcome assessments at baseline and at 1, 3, 6 and 12 months after injection. The primary outcome was improvement in the VAS score for pain. Secondary outcomes included changes in ASES score, SANE score and the Pittsburgh Sleep Quality Index (PSQI). Treatment failure was defined as persistent pain at 3 months which required a subsequent injection. ResultsThe mean age was 27.7 (±7.4). All the patients completed 12 months clinical follow-up. At 12 months, patients in the PRP group showed a significantly greater improvement in the VAS than patients in the CS group 1.68(0.6) vs 2.3(1.0) (p<0.001). As well, at 12 months follow-up, the 3 scores evaluated were significantly higher in patients treated with PRP than in patients treated with CS ASES 89.8 (6.3) vs 78.0 (8.6) (p<.001); SANE 89.2 (6.3) vs 80.5 (9.6) (p< .001) and PSQI 2.72 (0.6) vs 4.02 (1.7) (p< .001)The overall failure rate, was significantly higher in the CS group (30%) than in the PRP group (12%) (p<0.01) ConclusionOne subacromial PRP injection in patients with rotator cuff tendinopathy showed significantly superior and sustained pain-relieving and functional improvements compared with one corticosteroid subacromial injection assessed by 4 patient-reported outcome scales at 12 months of follow-up. Moreover, the overall failure rate, was significantly higher in the CS group than in the PRP group.

Ultrasound with Elastography versus MRI in Diagnosis of Rotator Cuff Tendinopathy

Abstract Background tendinopathies and tendon injuries that are due to overload, are important and extremely widespread problem in musculoskeletal diseases. Real-time Sonoelastography (SE) is used to evaluate the tissue elasticity. Aim This study assessed the role of sonoelastography in evaluation of tendon stiffness in comparison to the magnetic resonance imaging (MRI) in diagnosis of patients with rotator cuff (RC) tendinopathy. Methods cross sectional study with 36 adult patients that were clinically suspected to have supraspinatus tendinopathy with no past history of trauma and performed MRI of the shoulder were selected for our study. SE images were taken and assessed for focal soft areas. The supraspinatus (SSP) tendinopathy was graded (Grade 0, normal; Grade I, mild tendinopathy; Grade II, moderate tendinopathy; and Grade III, marked tendinopathy). Results the examined population, by MRI examination of supraspinatus tendon findings categorized as 7 patients (19.4%) had grade 0, and 17 patients (47%) had grade 1, 11 (30.6%) had grade 2, and 1 (2.8%) had grade 3. On the other hand, by Sonoelastography, there was 8 patients (22.2%) had grade 0, and 18 patients (50%) had grade 1, 9 (25%) had grade 2, and 1 (2.8%) had grade 3. Perfect positive correlation (r = 0.83) was found between the MRI and Sonoelastography grading. The association between the two modalities was statistically significant (p &amp;lt; 0.01). Conclusions SE showed good correlation with MRI in identifying supraspinatus tendon intratendinous alterations.

Metrology of Supraspinatus Tendon Thickness in Swimmers with Tendinopathy Using Ultrasound Imaging: An Intra- and Inter-Rater Reliability Study.

Objective: This study aimed to assess the relative and absolute intra- and inter-rater reliability of supraspinatus tendon (SST) thickness. Materials: Thirty adolescent swimmers with supraspinatus (SS) tendinopathy (n = 15) and a control-matched group (n = 15) were evaluated. Tendon thickness was measured according to four different measure procedures, i.e., (1) at 15 mm, (2) at 10, 20, and 30 mm, (3) at 10, 15, and 20 mm, and (4) 5 and 10 mm lateral to the most hyperechogenic reference point of the biceps tendon. Each examiner took two US images for the test measurements with a 10 min rest period. After 30 min, the subjects underwent retest measurements that were also repeated 1 week later. Results: SST thickness was greater in swimmers with SS tendinopathy compared with the matched control group for each procedure and rater (p < 0.001). Intra- and inter-rater reliability was good to excellent (ICC2.3: 0.78-0.98 and 0.83-0.97, respectively) in both groups. The lowest intra- and inter-rater reliability was found in procedures no. 2 and 4 (ICC2.3: 0.78 and 0.83). However, procedure no. 3 was the most reliable with the lowest error rate (ICC2.3: 0.92-0.97; SEM: 0.05-0.10 mm; MDC: 0.14-0.28 mm). Conclusions: The study confirmed the diagnostic value of ultrasound in SS tendinopathy. A multiple-reference-point procedure including a simple methodology (10, 15, and 20 mm from biceps tendon), was defined as the most reliable, expressed by the highest intra- and inter-rater ICCs.

Predictive Prognostic Factors in Non-Calcific Supraspinatus Tendinopathy Treated with Focused Extracorporeal Shock Wave Therapy: An Artificial Neural Network Approach.

The supraspinatus tendon is one of the most involved tendons in the development of shoulder pain. Extracorporeal shockwave therapy (ESWT) has been recognized as a valid and safe treatment. Sometimes the symptoms cannot be relieved, or a relapse develops, affecting the patient's quality of life. Therefore, a prediction protocol could be a powerful tool aiding our clinical decisions. An artificial neural network was run, in particular a multilayer perceptron model incorporating input information such as the VAS and Constant-Murley score, administered at T0 and at T1 after six months. It showed a model sensitivity of 80.7%, and the area under the ROC curve was 0.701, which demonstrates good discrimination. The aim of our study was to identify predictive factors for minimal clinically successful therapy (MCST), defined as a reduction of ≥40% in VAS score at T1 following ESWT for chronic non-calcific supraspinatus tendinopathy (SNCCT). From the male gender, we expect greater and more frequent clinical success. The more severe the patient's initial condition, the greater the possibility that clinical success will decrease. The Constant and Murley score, Roles and Maudsley score, and VAS are not just evaluation tools to verify an improvement; they are also prognostic factors to be taken into consideration in the assessment of achieving clinical success. Due to the lower clinical improvement observed in older patients and those with worse clinical and functional scales, it would be preferable to also provide these patients with the possibility of combined treatments. The ANN predictive model is reasonable and accurate in studying the influence of prognostic factors and achieving clinical success in patients with chronic non-calcific tendinopathy of the supraspinatus treated with ESWT.

Assessment of shoulder joint derangements with magnetic resonance imaging in adult Nigerians.

Shoulder pain secondary to various aetiologies is a common musculoskeletal complaint worldwide, and Magnetic Resonance Imaging (MRI) is the most accurate imaging method for evaluating shoulder pain in all age groups. While the patterns of shoulder MRI abnormalities in various demographics have been reported, data on sub-Sahara African populations are still sparse. This study aims to describe the imaging features and spectrum of shoulder joint pathologies on MRI in adult Nigerians. This was a retrospective review of the shoulder MRI of 100 adult Nigerians (with and without trauma) from September 2020 to December 2021. Their clinical data and shoulder MRI findings were extracted and analysed. Statistical significance was set at P ≤ 0.05. There were 64 males and 36 females aged 18-82 years. Right shoulder MRI was done in 53 subjects (53%), while the left shoulder was studied in 47 (47%). Supraspinatus tendinopathy (73%), acromioclavicular joint arthropathy (68%), and subacromial-subdeltoid (SASD) bursitis (64%) were the most frequently detected pathologies. Other demonstrated derangements include glenohumeral joint effusion (24%), long head of biceps tendon sheath effusion (18%), labral abnormalities (16%), subcoracoid bursitis (4%), Hill Sach's deformity (3%), anterior glenohumeral dislocation (2%), fatty degeneration of the supraspinatus/infraspinatus muscles (2%), adhesive capsulitis (1%), and other bony abnormalities (contusion, erosion, subchondral cysts). There was no significant difference in the frequency of shoulder abnormalities between the male and female subjects. Acromioclavicular joint arthropathy, SASD bursitis, and rotator cuff disorders were the dominant pathologies in the participants' shoulders.

Structural and Functional Changes in Supraspinatus Tendinopathy through Percutaneous Electrolysis, Percutaneous Peripheral Nerve Stimulation and Eccentric Exercise Combined Therapy: A Single-Blinded Randomized Clinical Trial.

Shoulder tendinopathies produce pain and reduce functionality. The aim of this randomized clinical trial was to analyze the effects of Percutaneous electrolysis (PE), Percutaneous peripheral Nerve Stimulation (PNS) and eccentric exercise (EE) on pain (NPRS), strength, electromyographic activity, ultrasound characteristics of the tendon (echogenicity, thickness and hypervascularization) and functionality (DASH and SPADI) in individuals with supraspinatus tendinopathy. Participants (n = 50) were divided into two groups; they received 4 treatment sessions, 1 per week, of PE and PNS (n = 25) or 10 treatment sessions of TENS and US (n = 25). Both groups performed the EE program consisting of 3 sets of 10 repetitions of each of the 3 exercises, twice a day, during the 4 weeks. Follow-up was carried out at 4, 12 and 24 weeks after the start of the intervention. There are statistically significant differences in the analysis between groups (p < 0.001) in the post-treatment and follow-up measurements favorable to the PE+PNS+EE treatment on pain (NPRS), strength, supraspinatus electromyographic amplitude, ultrasound characteristics of the tendon (echogenicity, thickness and hypervascularization) and DASH and SPADI questionnaires. The combined treatment with PE, PNS and EE is an effective option in the clinical management of tendinopathies, with positive results in the short and long term on the variables studied.

Role of Ultrasound Guided Platelet Rich Plasma Therapy for Isolated Supraspinatus Tendinopathy

Background: Rotator cuff (RC) injuries are not so uncommon a cause of disability among the population. The RC stabilizes the shoulder, a highly unstable joint owing to great mobility. Supraspinatus (SS) is one of the RC tendons undergoing damage ranging from mild tendinosis to complete tear due to degeneration, trauma, or other causes. Supraspinatus tears (STs) have been classically treated conservatively with physical and pharmacotherapy and later on with the help of surgical repair. Non-surgical treatment with biologics like platelet-rich plasma (PRP) therapy has been tried with positive results but with limited data. We aim to identify the role of PRP therapy in patients with symptomatic supraspinatus tendinopathy (STP) for improving the range of motion as well as reducing the pain and physical disability.Methods: This study was done on fifty symptomatic STP patients who failed medical and physical therapy for at least three months. The improvement in the pain score following two sittings of PRP therapy was evaluated with numerical rating scale (NRS). The improvement of the function of shoulder joint movements for daily activities was assessed with the modified University of California-Los Angeles (UCLA) shoulder score. Moreover, NRS, tear size (TS, assessed with ultrasound), Constant Shoulder Score (CSS), and modified UCLA shoulder score were recorded at baseline, and subsequently at 1-month, 3-months, and 6-months following the second sitting of the PRP therapy.Results: At baseline, the CSS was 36.42±5.12, and was 61.58±6.35, 81.22±6.23, and 87±3.9 at 1-month, 3-months, and 6-months follow-up, respectively. The NRS was 8.18±0.96 before the procedure and 4.26±0.8, 2.02±0.62, 1.84±0.51 at 1-month, 3-months, and 6-months follow-up, respectively. The mean TS pre-procedure was 3.12±0.89, and a significant decrease in TS was seen at 1-month (2.87±0.88), 3-months (2.44±0.79), and 6-months (2.17±0.76). Modified UCLA score was 16.86±3.49 at baseline which improved to 24.66±3.17 at 1-month, 31.64±2.69 at 3-months, and 32.5±1.67 at 6-months.Conclusion: PRP results in healing of the torn SS tendon. It also reduces pain score, improve range of motion and quality of life of the patients.

The Efficiency of Gray-Level Ultrasound Histogram Analysis in Patients with Supraspinatus Tendinopathy.

Musculoskeletal ultrasonography is a viable substitute for magnetic resonance imaging (MRI) that offers advantages in terms of time efficiency and cost-effectiveness. The gray-level histogram is a tool used to depict the distribution of pixel gray levels that provide quantitative data. The objective of our research was to establish a threshold value for ultrasonography-measured supraspinatus tendon gray-level values by comparing patients with tendinopathy to those without. This study comprised a cohort of 271 individuals, consisting of 124 patients diagnosed with supraspinatus tendinopathy and 147 cases without the aforementioned condition who underwent shoulder MRI and ultrasound examinations. Two radiologists independently conducted the gray-level histogram analyses. The histogram parameters were determined, including the mean, minimum, median, maximum, fifth, 10th, 25th, 50th, 75th, 90th, and 95th percentiles, as well as skewness, kurtosis, and variance. The interobserver agreement was evaluated using the interclass correlation coefficient. The supraspinatus tendinopathy group's all gray-level values were lower than those of the control group, and the difference was statistically significant (P < .05). The supraspinatus tendinopathy group exhibited greater values of skewness and kurtosis in comparison to the control group (P < .05). The area under the curve of the 95th percentile of the gray-level value was the highest (area under the curve = 0.960; cut-off value = 82.5; sensitivity = 96.7%; specificity = 88.2%). The analysis of the histogram of gray-level values has the potential to be a promising method for the monitoring of patients with supraspinatus tendinopathy. This approach could be considered a feasible alternative to MRI.

The Effect of Oriental Medicine Treatments for Supraspinatus Tendinopathy: Systematic Review and Meta-Analysis

The Effect of Oriental Medicine Treatments for Supraspinatus Tendinopathy: Systematic Review and Meta-Analysis

Shoulder ultrasound imaging in the post-stroke population: a systematic review and meta-analysis.

Post-stroke shoulder pain is a serious challenge for stroke survivors. The aim of this meta-analysis was to review the literature to confirm information on structural changes in post-stroke shoulders detected by ultrasound examination. PubMed, Embase, Web of Science and ClinicalTrials.gov were searched until 7 December 2022, for studies describing shoulder sonographic findings in stroke patients. Two independent authors selected the studies, extracted the data, and performed the critical appraisal. A total of 23 clinical studies were included. The most prevalent pathologies in hemiplegic shoulders pertained to the biceps long head tendon (41.4%), followed by the supraspinatus tendon (33.2%), subdeltoid bursa (29.3%), acromioclavicular joint (15.0%), and subscapularis tendon (9.2%). The common pathological findings encompassed bicipital peritendinous effusion (39.2%), biceps tendinopathy (35.5%), subdeltoid bursitis (29.3%) and supraspinatus tendinopathy (24.6%). Biceps long head tendon and supraspinatus tendon abnormalities were observed significantly more in the hemiplegic (vs contralateral) shoulders, with odds ratios of 3.814 (95% confidence interval 2.044-7.117) and 2.101 (95% confidence interval 1.257-3.512), respectively. No correlation was observed between motor function and shoulder pathology. Ultrasonography enabled the identification of common shoulder pathologies after stroke. Further research is needed to establish the association between these changes and the clinical course of stroke patients.

Ultrasonographic appearance of supraspinatus and biceps tendinopathy improves in dogs treated with low-intensity extracorporeal shock wave therapy: a retrospective study.

This study aimed to determine whether dogs with shoulder tendinopathy diagnosed via musculoskeletal ultrasound would show improvement in imaging after treatment using piezoelectric shockwave therapy and rest. Medical records were reviewed for dogs diagnosed with biceps and/or supraspinatus tendinopathy via musculoskeletal ultrasound, treated using piezowave shockwave, and re-imaged post-treatment. Data collected included patient signalment, duration and grade of lameness, prior rest, piezowave dose, and patient outcome, including a return to sport where applicable. Images were scored using an adapted ultrasound grading scale, in addition to obtaining cross-sectional area measurements. Statistics included Shapiro-Wilk tests (normality), Wilcoxon matched pairs signed rank tests (pre- vs. post-treatment comparisons), and Spearman's correlation coefficients (lameness grade vs. ultrasound score) (significant at P < 0.05). In total, 26 of 30 dogs had pathology involving both the biceps and supraspinatus tendons in one limb, with 27 of 30 having tendon/s affected bilaterally. For both tendons, post-treatment cross-sectional area and ultrasound score were significantly lower than pre-treatment (P < 0.001). Lameness decreased clinically (P < 0.0001) following piezowave shockwave treatment regardless of the tendons involved, but the lameness score did not correlate with the ultrasound score for either tendon. Dogs with tendinopathy of the biceps brachii and supraspinatus showed significant improvement on follow-up musculoskeletal ultrasound and lameness evaluation after the treatment of their tendons using piezoelectric shockwave therapy with rest. Canine biceps brachii and supraspinatus tendinopathy can cause variable lameness and ultrasonographic appearance, which improves after shockwave therapy and rest. The ultrasound scoring system and cross-sectional area assessment provide useful outcome measures for clinical cases.

Role of ultrasound elastography in the evaluation of rotator cuff tendon in patients with shoulder pain and its comparison with magnetic resonance imaging

Background: Pain in the shoulder is the third-most prevalent musculoskeletal pain type. Most frequently involved in tendinopathy/tendon tears is the supraspinatus tendon, followed by a combination of the supraspinatus and infraspinatus tendon. At present, gray-scale ultrasound and MRI are used to determine the tear size, gross morphology, and postsurgical tendon repair. However, they are unable to determine the material characteristics of the muscle or tendon. Aims and Objectives: The aim of this study is to assess the role of ultrasound elastography in the evaluation of the rotator cuff tendon and to compare gray scale ultrasound and shear wave elastography (SWE) findings of the supraspinatus tendon with MRI in patients with shoulder pain. Materials and Methods: This prospective observational study included 50 patients. They were examined using a 1.5-T MRI machine and the ACUSON S3000 (Siemens Medical Solution) machine. The radiologist performing the ultrasound was blinded by the results of the MRI. Results: Age varied from 19 to 75 years. The majority (34%) were in the range of 31–40 years. Males were predominately affected. In MRI, the most common type of injury was mild tendinosis (34%), followed by moderate/severe tendinosis (26%). About 30% were diagnosed with moderate/severe tendinosis, 24% with mild tendinosis, 22% with partial tears, and 18% with full-thickness tears in gray-scale ultrasound. When SWE was combined, 32% were diagnosed with moderate/severe tendinosis, 28% with mild tendinosis, 20% with a partial tear, and 14% with a full-thickness tear. Conclusion: SWE showed better diagnostic performance than gray-scale ultrasound in the detection of supraspinatus tendinopathy.

Association between Pain and Level of Disability in Patients with Degenerative Supraspinatus Tendinopathy

Objective: To determine the association between pain and level of disability in participants with degenerative supraspinatus tendinopathy. Study Design: Cross-sectional study Place and Duration of Study: Outpatient Departments of Jinnah Hospital and Lahore General Hospital, Lahore Pakitan, from Jun 2019 to Feb 2020. Methodology: A total of 168 diagnosed participants of degenerative supraspinatus tendinopathy with age range of 30 to 60 years were included through consecutive sampling and questioned using Quick Disabilities of Arm, Shoulder and Hand (DASH) and Numeric pain rating scale. The categorical data like age and Quick Disabilities of Arm, Shoulder and Hand scores were recorded as mean and standard deviation while numerical data like gender and Numeric Pain Rating Scale readings were described as frequencies and percentages, using SPSS version 25.0. Linear relationship of association between pain and level of disability was found through Pearson coefficient (r). Results: Quick Disabilities of Arm, Shoulder and Hand (DASH)showed a mean of 3.55 and standard deviation of 0.94, while with Numeric Pain Rating Scale 7 participants (4.2%) described their level of pain as "hurts little bit", 31(18.5%) "Hurts little more", 63(37.5%) "Hurts even more", 55(32.7%) "Hurts whole lot" and 12(7.1%) "Hurts worst”. Results of the study showed that level of disability was significantly correlated with pain and there was a moderate positive correlation between them. Conclusion: This study concluded that intensity of pain can cause disability in participants with degenerative supraspinatus tendinopathy and impairs the Quality of Life in such patients.

Extracorporeal Shock Wave Therapy versus Local Corticosteroid Injection and Platelet-Rich Plasma in The Treatment of Supraspinatus Tendinopathy

Extracorporeal Shock Wave Therapy versus Local Corticosteroid Injection and Platelet-Rich Plasma in The Treatment of Supraspinatus Tendinopathy

Acoustic Radiation Force Impulse (ARFI) Elastography in Evaluation of Supraspinatus Tendinopathy.

The most common etiology of shoulder pain in adults is rotator cuff tear. Elastography is an imaging method that can report the strain and elastic modulus of the biological tissue. We think acoustic radiation force impulse (ARFI) elastography can effectively assess rotator cuff tendinopathy. This study aimed to investigate the usefulness of ARFI elastography in evaluating supraspinatus tendinopathy. We included 44 patients (22 men, 22 women, median age, 47 years; range, 20-69 years) with unilateral supraspinatus tendinopathy diagnosed with magnetic resonance imaging (MRI) in this prospective study. The normal tendons and tendinopathies, including supraspinatus tendinosis, partial-thickness, and full-thickness supraspinatus tears, were evaluated with ultrasound and ARFI elastography. The ARFI elastography values were compared between healthy and tendinopathy groups, and the gender was compared between elastography values of the normal tendons and tendinopathies using the Mann-Whitney U test. The values of ARFI elastography correlated with tendinopathy. (P = 0.001). The gender differed between the elastography values of the normal tendons (P = 0.002) and tendinopathies (P = 0.001). ARFI elastography is a non-invasive and feasible method for quantitatively assessing supraspinatus tendinopathy. It can be an alternative method to MRI in diagnosing supraspinatus tendinopathy.

Effects of Blood Flow Restriction on Pain and Muscle Thickness Following Tendinopathy: A Case Study

Introduction: Blood flow restriction (BFR) training, in which an inflatable cuff partially occludes blood flow around the proximal portion of a limb, coupled with low-load resistance exercise (LLRE) has resulted in gains comparable with traditional progressive resistive exercise in healthy populations. The use of BFR with LLRE may help people with supraspinatus tendinopathy through proximal effects to improve strength and muscle size. The purpose of this case report is to describe the proximal effect of the LLRE+BFR program on a patient with supraspinatus tendinopathy.&#x0D; Materials and Methods: The patient was a 40-year-old man with a history of shoulder pain and weakness for the past months. He received an LLRE+BFR program for his right shoulder including rotator cuff and scapular strengthening exercises and lower limbs aerobic exercises based on protocols of strengthening and aerobic exercises of BFR. Outcomes measured at baseline and 4 weeks included the 4 items: 1) Strength of supraspinatus muscle and four scapular stabilizer muscles including serratus anterior strength, middle trapezius strength, and lower trapezius strength by dynamometer, 2) supraspinatus thickness by ultrasound, 3) pain pressure threshold of supraspinatus and deltoid muscles by algometer, and 4) pain reported bay in each session based on pain numeric scale.&#x0D; Results: After 6 weeks, the strength of supraspinatus and scapular stabilizers except for the lower trapezius increased. The supraspinatus thickness and pain pressure threshold in the supraspinatus and deltoid muscle also increased after 4 weeks. The mean of pain reported by the patient based on the pain numeric scale before and after each session was also decreased.&#x0D; Conclusion: The patient had measurable improvements following the use of an LLRE+BFR program. LLRE+BFR program may be an option for strength training in people with supraspinatus tendinopathy; however, more research is needed to determine effectiveness across the population of people with supraspinatus tendinopathy.&#x0D;

Needle contact test in auricular acupuncture for shoulder pain and where effective auricular acupoints identified are positioned on the map: A controlled study

Active Points Test on auricle was renamed Needle Contact Test (or NCT), considered an extremely effective method to select most efficient auricle acupoint for Auricular Acupuncture (or AA) therapy. Our aims were to evaluate NCT efficiency as viable diagnostic option to identify the most appropriate AA acupoints to be selected for SupraSpinatus Tendinopathy (SST) associated shoulder pain treatment and to evaluate which auricle area has greater concentration of NCT positive acupoints in subjects with SST shoulder pain, comparing results with available AA ear maps. 45 subjects with SST diagnosis were enrolled. On 30 subjects in treatment group, NCT was performed on acupoints of the auricle shoulder representation areas (i.e., Scaphoid Fossa), while in 15 subjects of control group, NCT was performed on auricle areas not shoulder associated. Statistically significant lower Numeric Pain Rating Scale scores were seen for study group over time and compared to control. A small sample showed statistically significant increase of SST shoulder maximum abduction range of Movements. NCT identified best SST shoulder pain AA acupoints in Scaphoid Fossa (or SF1 and SF2). In conclusion NCT is a viable tool to efficiently identify the best AA acupoints in SST shoulder pain treatment.

Sono-elastography findings of supraspinatus tendon in supraspinatus tendinopathy and tear: comparison study with magnetic resonance imaging

BackgroundRotator cuff disorders are the main causes of chronic shoulder instability and pain. Diagnostic imaging is important to guide treatment decisions with magnetic resonance imaging, which is considered the reference standard for rotator cuff evaluation. Sono-elastography is a noninvasive and reliable ultrasound technique that provides qualitative as well as quantitative assessment of tendon quality through alteration in the tissue composition before alteration in tendon echogenicity or thickness on the conventional US.PurposeTo assess the role of shear wave sonoelastography in the evaluation of supraspinatus tendon abnormalities.To assess the association between SWE and grades of tendon abnormalities on MRI (the standard imaging in the evaluation of rotator cuff abnormalities).ResultsThe shear wave velocity (SWV) was notably low (reduced tendon stiffness) in patients with supraspinatus tendinopathy and tear (mean SWV for the supraspinatus tendon in cases of tendinopathy/tear was 3.91 m/s with a standard deviation of 0.67, while the mean SWV for normal supraspinatus tendons was 6.93 m/s with a standard deviation 0.57), and a significant difference was found in SWV values between cases and controls (P < 0.001).Also, there were significant differences between the patients with different grades of tendon abnormalities (P < 0.001), with a highly significant inverse correlation observed between the measured SWV and grades of tendon abnormalities on MRI (P < 0.001).ConclusionsSonoelastography showed tendon softening in supraspinatus tendinopathy and tear with a good correlation to the MRI, making it a reproducible and low-cost imaging modality that can be a complementary tool to the US in the evaluation of shoulder disorders, especially when MRI is not allowed.