肩峰下滑液包炎・腱板炎および腱板不全断裂の超音波診断

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  • Sonographic Diagnosis of Subacromial Bursitis, Tendinitis and Incomplete Rotator Cuff Tears

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(Purpose)The purpose of this study is to evaluate the sonographic diagnosis of subacromial impingement syndrome (SIS) e. g. subacromial bursitis and/or tendinitis (Grade I) and incomplete rotator cuff tears(Grade II).<BR>(Materials and methods)83 cases of SIS were operated on from 1994 to 1996 after a sonographic examination using a Toshiba SSA-250A with a 7.5 MHz by the same staff member. There were 24 Grade I, 20 Grade II(8 bursal-side tears; BT,4 intratendinous tears; I T, and 8 joint-side tears; JT), and 39 Grade III (complete rotator cuff tears)lesions. The diagnostic criteria for Grade I were a thickend cuff tendon and/or fluid collection in the bursa, and for Grade II, surface irregularity and/or echogenic material in the cuff tendon. At operation, palpations, color tests and a trial tenotomy were variously employed to confirm any concealed pathology. Comparisons were made between the preoperative sonograms and operative findings.<BR>(Results)In Grade I lesions, the sensitivity was 41.7%, specificity,80%, positive predictive value,71.4%and accuracy,59.1%. In Grade II lesions, consisting of BT, It and JT, the sensitivities were 75%,50% and 12.5% respectively, specificies,80.6%,85% and 94.4%, the positive predictive values.46.2%,25% and 33.3%, and accuracies,79.5%,81.8% and 79.5%.<BR>(Discussion)This is the first report on the sonographic diagnostic rate concerning the BT, IT, and JT separately. The sonographic diagnosis of IT was effective.<BR>(Summary)1) Sonographic findings in subacromial bursitis, tendinitis and incomplete rotator cuff tears were compaired with the operative findings.2)The accuracy of the sonographic diagnosis was 59.1% in Grade I lesions and 79.5% in BT,81.8% in IT and 79.5% in JT.3) Sonographic screening of IT was useful in deciding on a trial tenotomy.

収録刊行物

  • Katakansetsu

    Katakansetsu 21 (2), 207-210, 1997

    Japan Shoulder Society

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