Ultrasound In The Diagnosis Of Under The Acromion Impingement

Objective:Analyze videograph features two-dimensional colored Doppler for subacromial impingement syndrome; discuss application value of ultrasound for diagnosis and recovery of subacromial impingement syndrome.Methods:Do examinations by using advanced ultrasonic equipment for patients who sit straight on the examination-bed; Observe the morphological changes of the rotator cuff and acromion shape and surface of the humeral head; make the evaluation of operation effects; trace to investigate patients’recovery process.32cases are our clinic and hospitalized patients,15males,17cases; the maximum age is67, the minimum age is40, average age is53;29advantage shoulder cases,3non-dominant shoulder cases; The longest duration is3years, the shortest is7days. Clinics take these followings evaluation indicators and methods as an important part in the standard:(1) Tenderness of acromion in the outer edge.(2) Abduction painful arc sign was positive when upper limb.(3) compared with the passive activity, pain is obvious in the initiative activities of shoulder joint.(4) Neer sign is positive.(5) acromion osteophytes, partial tear of the rotator cuff tear. Combined of medical history, occupation and clinical symptom, to meet three of the five criteria above, the subacromial impingement syndrome can be diagnosed. A combination of surgery and/or MRI can be confirmed to the diagnosis. Inclusion criteria:(1) Comply with three of the five diagnostic criteria above subacromial impingement syndrome.(2) older than10years;(3) education in post-primary. Exclusion criteria:(1) Neck shoulder lesions other than subacromial impingement syndrome.(2) The blood of patients with bleeding tendency or long-term aspirin using.(3) Existence of the allergy history of lidocaine hydrochloride.(4) Allergy to ultrasonic coupling agent;(5) people who due to special reasons can not accept the MRI and arthroscopic shoulder surgery;(6) Serious cardiovascular and cerebrovascular disease or organ failure can not be tolerated stimulate;(7) Diabetic patients suffer from limb ischemia or soft tissue infections tendency;(8) Mental illness and Alzheimer’s disease who can not meet the treatments and inspections.(9) who unwill to accept the study. Loss standard:By screening for entry to the study due to special reasons failling to complete the program provides relevant examination, take as a falling off cases. Statistical analysis:using Microsoft Excel2007program and the chi-square test to measure the gold standard and the correlation between ultrasonic examination. P-value is less than0.05, it represents the statistically significant. And do the calculation the sensitivity, specificity, positive and negative predictive prediction of the ultrasound examination. Use advanced ultrasound to observe the rotator cuff, acromial morphology and humeral head surface morphological changes in the sitting position inspection, at the same time compare with the shoulder MRI and the operation. Take the operation and MRI criteria for diagnosis as "gold standard" To evaluate the value of ultrasound diagnosis.Results:As compared to the results of MRI and operation, we have found that ultrasound can be clearly displayed subacromial impingement syndrome of the rotator cuff, acromion morphology and the surface of the morphological changes of the humeral head, can dynamically display the changes in the acromion and the humeral head impact, while mostly in compliance with the results of CT and MRI, that has been proved through operations on some cases.Conclusion:Colored ultrasonic examination should be cared clinically for it’s unique application value when used for the diagnosis of the subacromial impingement syndrome and the whole recovery process.