Scientific/Clinical Article| Volume 30, ISSUE 2, P214-220, April 2017

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Supraspinatus tendon micromorphology in individuals with subacromial pain syndrome


      Study Design

      Cross-sectional cohort.


      Tendon collagen organization can be estimated by peak spatial frequency radius (PSFR) on ultrasound images. Characterizing PSFR can define the contribution of collagen disruption to shoulder symptoms.

      Purpose of the Study

      The purpose of this was to characterize the (1) supraspinatus tendon PSFR in participants with subacromial pain syndrome (SPS) and healthy controls; (2) PSFR between participants grouped on a tendon visual quality score; and (3) relationship between PSFR with patient-reported pain, function, and shoulder strength.


      Participants with SPS (n = 20) and age, sex, and arm-dominance–matched healthy controls (n = 20) completed strength testing in scaption and external rotation, and patient-reported pain, and functional outcomes. Supraspinatus tendon ultrasound images were acquired, and PSFR was calculated for a region of interest 15 mm medial to the supraspinatus footprint. PSFR was compared between groups using an independent t-test and an analysis of variance to compare between 3 groups for visually qualitatively rated tendon abnormalities. Relationships between PSFR with pain, function, and strength were assessed using Pearson correlation coefficient.


      Supraspinatus tendon PSFR was not different between groups (P = .190) or tendon qualitative ratings (P = .556). No relationship was found between PSFR and pain, functional loss, and strength (P > .05).


      Collagen disruption (PSFR) measured via ultrasound images of the supraspinatus tendon was not different between participants with SPS or in those with visually rated tendon defects. PSFR is not related to shoulder pain, function, and strength, suggesting that supraspinatus tendon collagen disorganization may not be a contributing factor to shoulder SPS. However, collagen disruption may not be isolated to a single region of interest.

      Level of Evidence

      3b: case-control study.

      Key words

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      JHT Read for Credit

      Quiz: #479

      Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to There is only one best answer for each question.
      • #1.
        The study design is best described as
        • a.
        • b.
        • c.
          a case series
        • d.
          a cross sectional cohort
      • #2.
        Tendinous collagen organization was studied by
        • a.
        • b.
        • c.
          estimates of PSFR utilizing an ultrasonic technique
        • d.
          determining the PRSO with an electronic microscopic technique
      • #3.
        Strength testing was performed in
        • a.
          scaption and external rotation
        • b.
          elevation and internal rotation
        • c.
          external rotation with the arm at the side
        • d.
          internal rotation with the arm behind the back
      • #4.
        Statistical analysis included
        • a.
          three ANOVAs
        • b.
          an ANOVA and a Pearson correlation coefficient
        • c.
          a student t-test and two standard deviations
        • d.
          none of the above
      • #5.
        There was no significant correlation between pain and PSFR
        • a.
        • b.
      When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.