Abstract
Study Design
Cross-sectional cohort.
Introduction
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.
Methods
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.
Results
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).
Conclusions
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
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Hand TherapyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Incidence of non-traumatic complaints of arm, neck and shoulder in general practice.Man Ther. 2008; 13: 426-433
- Prevalence and incidence of shoulder pain in the general population; a systematic review.Scand J Rheumatol. 2004; 33: 73-81
- The Shoulder Pain and Disability Index demonstrates factor, construct and longitudinal validity.BMC Musculoskelet Disord. 2006; 7: 12
- Rotator cuff tendinopathy/subacromial impingement syndrome: is it time for a new method of assessment?.Br J Sports Med. 2009; 43: 259-264
- Mechanisms of rotator cuff tendinopathy: intrinsic, extrinsic, or both?.Clin Biomech (Bristol, Avon). 2011; 26: 1-12
- Patellar tendon morphology in volleyball athletes with and without patellar tendinopathy.Scand J Med Sci Sports. 2013; 23: 81-88
- Ultrasound-based tendon micromorphology predicts mechanical characteristics of degenerated tendons.Ultrasound Med Biol. 2016; 42: 664-673
- Tendinopathy discrimination by use of spatial frequency parameters in ultrasound b-mode images.IEEE Trans Med Imaging. 2008; 27: 608-615
- Accuracy of MRI, MR arthrography, and ultrasound in the diagnosis of rotator cuff tears: a meta-analysis.AJR Am J Roentgenol. 2009; 192: 1701-1707
- Supraspinatus tendon and subacromial space parameters measured on ultrasonographic imaging in subacromial impingement syndrome.Knee Surg Sports Traumatol Arthrosc. 2015; 23: 363-369
- Increased palpation tenderness and muscle strength deficit in the prediction of tendon hypertrophy in symptomatic unilateral shoulder tendinopathy: an ultrasonographic study.Physiotherapy. 2009; 95: 83-93
- Ultrasound measurements on acromio-humeral distance and supraspinatus tendon thickness: test-retest reliability and correlations with shoulder rotational strengths.J Sci Med Sport. 2012; 15: 284-291
- Ultrasonographic measures of the acromiohumeral distance and supraspinatus tendon thickness in manual wheelchair users with spinal cord injury.Arch Phys Med Rehabil. 2017; 98: 517-524
- The management of partial-thickness tears of the rotator cuff.J Bone Joint Surg Br. 2003; 85: 3-11
- Arthroscopic treatment of partial rotator cuff tears in young athletes.Am J Sports Med. 1997; 25: 299-305
- Reliability and diagnostic accuracy of 5 physical examination tests and combination of tests for subacromial impingement.Arch Phys Med Rehabil. 2009; 90: 1898-1903
- The Penn Shoulder Score: reliability and validity.J Orthop Sports Phys Ther. 2006; 36: 138-151
Beggs I, Bianchi S, Bueno A, et al. Musculoskeletal Ultrasound Technical Guidelines I. Shoulder. European Society of MusculoSkeletal Radiology. Available at: https://essr.org/content-essr/uploads/2016/10/shoulder.pdf. Accessed November 10, 2015.
- Tendinopathy discrimination using spatial frequency parameters and artificial neural networks.in: IEEE International Ultrasonics Symposium Proceedings. 2009: 1902-1905
- A systematic review of the histological and molecular changes in rotator cuff disease.Bone Joint Res. 2012; 1: 158-166
- Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy.Br J Sports Med. 2009; 43: 409-416
- Modulation of aggrecan and ADAMTS expression in ovine tendinopathy induced by altered strain.Arthritis Rheum. 2008; 58: 1055-1066
- Tendons, ligaments, and capsule of the rotator cuff. Gross and microscopic anatomy.J Bone Joint Surg Am. 1992; 74: 713-725
- Plasticity of muscle architecture after supraspinatus tears.J Orthop Sport Phys Ther. 2010; 40: 729-735
- Pain inhibition of shoulder strength in patients with impingement syndrome.Orthopedics. 1994; 17: 685-688
- Experimental pain inhibits infraspinatus activation during isometric external rotation.J Shoulder Elbow Surg. 2013; 22: 478-484
- Association of strength measurement with rotator cuff tear in patients with shoulder pain.Am J Phys Med Rehabil. 2016; 95: 47-56
- The effect of rotator cuff tear size on shoulder strength and range of motion.J Orthop Sports Phys Ther. 2005; 35: 130-135
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 JHTReadforCredit.com. There is only one best answer for each question.
- #1.The study design is best described as
- a.qualitative
- b.RCTs
- c.a case series
- d.a cross sectional cohort
- a.
- #2.Tendinous collagen organization was studied by
- a.MRI
- b.biopsy
- c.estimates of PSFR utilizing an ultrasonic technique
- d.determining the PRSO with an electronic microscopic technique
- a.
- #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
- a.
- #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
- a.
- #5.There was no significant correlation between pain and PSFR
- a.false
- b.true
- a.
When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.
Article info
Publication history
Published online: May 11, 2017
Accepted:
April 11,
2017
Received in revised form:
March 14,
2017
Received:
December 7,
2016
Identification
Copyright
© 2017 Hanley & Belfus, an imprint of Elsevier Inc. All rights reserved.
