Clinical Study Of Musculoskeletal Ultrasound Scanning Of The Posterior Part Of The Shoulder In The Frozen Shoulder

Objective:To explore the clinical significance of musculoskeletal ultrasound scanning of the posterior capsule thickness and glenohumeral distance at the back of the shoulder in the frozen shoulder staging.Methods:From July to November 2018,100 patients with clinically diagnosed unilateral frozen shoulders were recruited in the Department of rehabilitation of Shanxi Dayi Hospital,and 50 normal person were selected.According to the clinical staging criteria,the affected shoulders of the frozen shoulder group were divided into the freezing phase(Phase I)51 shoulders,frozen phase(II phase)35 shoulders,the thawing phase(III phase)14 shoulders,a total of 3 groups,and the control group was the respective lateral shoulders of 3 group patients with frozen shoulder.50 person were in the normal group,100 shoulders.The pain score(VAS),Passive range of motion(PROM),and Constant-Murley score(CMS)of the frozen shoulder group were firstly evaluated.The ultrasound was used to scan the posterior capsule of shoulder and glenohumeral distance of the bilateral shoulder joints of each frozen shoulder patient and normal person.Ultrasound findings of the posterior capsule thickness of shoulder and glenohumeral distance of patients with stage I,II,III and normal patients were observed,and the posterior capsule thickness(PCT)and glenohumeral distance(GHD)were measured separately.Statistical analysis was performed by variance analysis to compare the differences in PCT and GHD on both sides of normal people,the difference of PCT and GHD between normal and frozen shoulders,and the difference of PCT and GHD between the affected shoulder and the unaffected shoulder of patients with frozen shoulder I,II and III.Correlation analysis was used to evaluate the correlation between PCT and GHD and clinical indicators(VAS,PROM,CMS)in patients with frozen shoulder.Results:There was no significant difference in PCT and GHD between the normal group(P>0.05).There was no significant difference between normal people and frozen shoulder PCT and GHD(P>0.05).In the Phase I,the margin of the posterior capsule of the affected shoulder was clear.There was no significant difference between the affected side and the unaffected side(P>0.05)in PCT,while the GHD of the affected side was larger than that of the unaffected side(3.14±0.44 mm vs 2.22±0.35 mm,P <0.05),the difference was statistically significant;In the Phase ?,the margin of the posterior capsule of the affected shoulder was blurred,and the PCT of the affected side was thicker than that of the unaffected side(1.45±0.30 mm vs 1.05±0.25 mm,P<0.05),the difference was statistically significant.The GHD of the affected side was smaller than the unaffected side(1.83±0.30 mm vs 2.22±0.35 mm,P<0.05),the difference was statistically significant.In the frozen Phase ?,the margin of the posterior capsule of the affected shoulder was was clearer.There was no statistical significance difference between the affected side and the unaffected side in PCT and GHD(P>0.05).The GHD of patients with frozen shoulder in the Phase I was positively correlated with VAS scores at rest,during activities,and during sleep(r=0.30,r=0.35,r=0.31,P<0.05).Conclusion:1.Ultrasound scanning of the posterior capsule thickness and glenohumeral distance at the back of the shoulder can contribute to diagnose the clinical staging of the frozen shoulder.2.There was a positive correlation between the glenohumeral distance and pain in patients with frozen shoulder stage ?.