The spectrum of radiographic and sonographic findings in patients with shoulder pain at the department of diagnostic imaging and radiation medicine, University of Nairobi

Abstract

*I. Mathenge was inadvertently mixed name and initials. The name should read I.M. Muriithi

Background: Shoulder pain is a common complaint. 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 the primary imaging modality in shoulder pain but is limited in the evaluation of the soft tissues. MRI is the chief modality used in the evaluation of shoulder soft tissues both locally and elsewhere but is limited by cost and availability. Shoulder ultrasonography is a cost effective modality for evaluating the soft tissues but is underutilized locally. No data is available in our local population regarding spectrum of findings in shoulder radiographs and ultrasound.
Objective: This study was designed to determine the spectrum of shoulder radiographic and sonographic findings in patients with shoulder pain.
Setting: Department of Diagnostic Imaging and Radiation Medicine, University of Nairobi. It is located within the old wing of Kenyatta National Hospital.
Design: This was a cross sectional descriptive study.
Subjects: A total of 72 patients with shoulder pain who were referred for shoulder radiographs.
Method: The study was conducted over a period of four months between the months of January 2016 to April 2016. Seventy two consecutive patients with shoulder pain 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. No surgery findings were available to correlate with the imaging findings.
Results:. Radiographs identified abnormalities in 36 (50%) patients’ majority of which were degenerative changes. Ultrasound identified abnormalities in 57 (79%) patients with the bulk of lesions seen within the rotator cuff. There was statistically significant association between presence of greater tuberosity degenerative changes and rotator cuff tears (p<0.001).
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.