Dynamic Ultrasound in Shoulder Impingement

March 2, 2020 updated by: Marwa Ismail Ahmed Mohammed, Assiut University

Role of Ultrasound in Shoulder Impingement

  • To evaluate the role of dynamic ultrasound in evaluation patient with clinically suspected shoulder joint impingement.
  • To assess the added value of dynamic ultrasonography to the static examination of patients with clinically suspected impingement.

Study Overview

Status

Unknown

Conditions

Intervention / Treatment

Detailed Description

Shoulder impingement syndromes and degenerative rotator cuff (RC) disease represent the main causes of shoulder pain . Impingement is classified into four types, depending on the site of soft-tissue entrapment: sub acromial, sub coracoid, poster superior inner and anterosuperior inner impingement. The sub acromial impingement syndrome is by far the most common in practice. . The clinical symptoms of sub acromial impingement include nocturnal pain and progressive, limited range of motion. At clinical examination, there is a painful area at 80-120° elevation, which is worsened during downward movements Osteophytes, or an abnormal shape of the acromion, sub acromial spurs, and the acromioclavicular joint, are common causes of compression at the rotator cuff and the overlying subacromial-subdeltoid bursa . Ultrasonography (US) is a commonly performed examination for shoulder impingement, recommended by experts as the first-choice technique to evaluate various shoulder diseases. Shoulder impingement is the most common and well-recognized indication for dynamic US in the shoulder.

Dynamic evaluation can be done by shoulder abduction or flexion with the probe placed at the end of the acromion in the coronal plane or in the sagittal plane. The two important points to be checked for shoulder impingement are the humeral head depression and tendon/bursal impingement . Because humeral head depression is essential to make enough space for the rotator cuff to slide beneath the acromion, the center of the humeral head normally moves inferiorly in the latter half of the cycle during shoulder abduction. When the humeral head does not move inferiorly or abnormally moves superiorly, the space for the rotator cuffs and the subacromial-subdeltoid bursa decreases and subacromial impingement can occur .

Magnetic resonance imaging (MRI) is currently considered the reference standard for imaging of shoulder disorders. The strength of MRI lies in its ability to assess sonographically inaccessible areas such as labrum, deep parts of various ligaments, capsule, and areas obscured by bone . MRI is the imaging study of choice for classifying tendon retraction and assessing the shoulder musculature. Its main disadvantage is being a static evaluation of the shoulder joint . There are several advantages of Ultrasonography over MRI. Ultrasonography has the benefit of being a dynamic form of imaging as compared to the static MRI. Ultrasonography is portable, quick, and a more cost-effective method. It is also better tolerated by the patient and allows interaction with the patient, who can point at the symptomatic area, thus optimizing the diagnostic yield.

Study Type

Observational

Enrollment (Anticipated)

37

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

16 years to 73 years (Adult, Older Adult)

Accepts Healthy Volunteers

N/A

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

sample size was determined by using G*power version 3.1.9.2 for windows for power analysis .we estimated 37 patients to be included in the study with statistically power 95% and 0.05 as an alpha error

Description

Inclusion Criteria

  • All patients referred to the Radiology department with clinically suspected shoulder impingement. Inclusion Criteria:

Exclusion Criteria:

  • The following categories of patient will be excluded from the study.

    1. History of previous shoulder surgery.
    2. History of joint dislocation.
    3. Fracture to the shoulder girdle.
    4. Patient with contraindication to MRI.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Observational Models: Cohort
  • Time Perspectives: Prospective

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
comparison of dynamic ultrasound findings with MRI
Time Frame: Baseline
To determine the role of dynamic shoulder ultrasound in evaluation of patients with clinically suspected shoulder impingement
Baseline

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Assiut University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Anticipated)

March 1, 2020

Primary Completion (Anticipated)

March 1, 2021

Study Completion (Anticipated)

March 1, 2021

Study Registration Dates

First Submitted

February 27, 2020

First Submitted That Met QC Criteria

February 27, 2020

First Posted (Actual)

March 2, 2020

Study Record Updates

Last Update Posted (Actual)

March 4, 2020

Last Update Submitted That Met QC Criteria

March 2, 2020

Last Verified

March 1, 2020

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • ultrasound in shoulder

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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