MRI Findings of Shoulder Pain in Hemiplegic Stroke Patients

Transcription

1 Jpn J Rehabil Med 2009 ; : MRI MRI Findings of Shoulder Pain in Hemiplegic Stroke Patients Ayako MURAKAMI, Hajime YAGURA, Megumi HATAKENAKA, Masahito MIHARA, Hisashi TANAKA, Noriaki HATTORI, Ichiro MIYAI Abstract : The purpose of this study is to evaluate MRI findings for the shoulder pain in hemiplegic stroke patients in relation to clinical characteristics. We studied 18 hemiplegic patients with first-ever stroke presenting with shoulder pain in the affected side mean age SD years ; 8 men and 10 women ; 12 right and 6 left hemiplegia. All patients had shoulder pain during passive movements and 4 also had pain at rest. The mean duration from stroke onset to MRI was days. MRI revealed abnormal findings in all patients. Tendinosis of the long head of the biceps and supraspinatus tendon injuries were most frequently found. The tendinosis of the long head of the biceps was related to hemihypesthesia and a reduced range of motion for external rotation of the shoulder. The supraspinatus tendon injuries were related to older age and lower Fugl-Meyer FM and Functional Independence Measure FIM scores. The mean number of abnormal findings per patient was The patients with more than 3 abnormal findings were significantly older, had shorter duration from stroke onset and lower FM and FIM scores than those with less findings. It was suggested that those patients with more severe paresis might have more abnormal findings on their MRIs for shoulder pain. Jpn J Rehabil Med. MRI MRI Fugl-Meyer FM Functional Independence Measure FIM FM FIM MRI Key words : shoulder pain hemiplegia stroke magnetic resonance imaging MRI shoulderhand syndrome SHS 4, Neurorehabilitation, Research Institute, Morinomiya Hospital a_murakami@omichikai.or.jp 787

2 MRI magnetic resonance imaging MRI MRI 10,11 MRI MRI SD MRI Fugl-Meyer FM Functional Independence Measure FIM Modified Ashworth Scale MAS p-rom SHS light touch. 1 SHS 1 12 MRI T1 T2 T2 MRI AM T1 T2 T1 T2 fluid collection T1 T2 10,11,13 t c 2 MRI p 0.05 FM MAS p-rom FIM SHS 1 MRI SHS 1 MRI MRI ROM FM FIM ROM FM FIM MRI 788

3 MRI MRI MRI MRI A T2 fluid collection B T2 C T2 D T2 T1 789

4 MRI n 14 n 4 p n 12 n 6 p n 10 n 8 p ns ns ns ns ns ns ns ns ns ns MRI ns ns ns FM ns ns ns ns ns ns ROM ns ns ns ROM ns ns ns ROM ns MAS ns ns ns ns ns ns SHS ns ns ns FIM ns FIM ns ns FIM ns n 8 n 10 p n 7 n 11 p n 5 n 13 p ns ns ns ns ns ns ns ns ns ns ns MRI ns ns FM ns ns ns ns ns ns ns ns ROM ns ns ns ROM ns ns ns ROM ns ns ns MAS ns ns ns ns ns ns SHS ns ns ns FIM ns ns ns FIM ns ns ns FIM ns ns ns 790

5 MRI MRI MRI FM FIM 4 14 MRI MRI MRI MRI MRI 10, ROM MAS ROM ROM MRI 10, MRI ROM MRI MRI 3 n 10 4 n 8 p ns ns ns MRI FM ns ns ROM ns ROM ns ROM ns MAS ns ns SHS ns FIM FIM FIM

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