| Periarthritis of shoulder referred to as "periarthritis of shoulder",refers to the soft tissue around the shoulder joint inflammation,to joint capsule fibrosis or accompanied by articular cartilage surface wear as a disease of pathological changes.The disease tends to occur in people around the age of 50.With the aggravation of aging in China,the number of patients is increasing.The diagnosis and treatment of periarthritis of shoulder are also getting more and more attention.Periarthritis of shoulder is a self-limited disease,but a considerable number of patients without timely treatment of poor prognosis,leading to the functional activity of the affected side of the shoulder can not return to normal,there is significant muscle atrophy,muscle strength decline,more vulnerable to trauma,the disease repeated attacks,therefore,periarthritis of shoulder as soon as possible diagnosis and treatment is very important.Patients often present with slow onset,shoulder pain,aggravation at night,and limited range of motion,which seriously affects normal work and life.These clinical manifestations were mostly related to the pathological changes of soft tissue such as tendons,ligaments and joint capsules,but X-ray examination could not clearly show these lesions and had certain limitations.Musculoskeletal ultrasound has obvious advantages in displaying the fine structure of soft tissue,and can accurately,clearly and dynamically image the lesion location and range of periarthritis of shoulder.With the development of musculoskeletal ultrasound imaging technology and the rich experience of clinicians,musculoskeletal ultrasound has been widely used in the auxiliary examination of periarthritis of shoulder.Western medicine often uses arthroscopic surgery or articular cavity puncture in clinical scapulohumeral periarthritis,but there are incomplete treatment or repeated problems,which bring psychological and physiological discomfort to patients.Traditional Chinese medicine treatment of periarthritis of shoulder various methods,in the clinical more accepted by patients.However,the syndrome differentiation of Chinese medicine is from the overall consideration of the body,for the local syndrome differentiation of periarthritis of shoulder is still controversial.This study will analyze the correlation between the ultrasonic image characteristics of periarthritis of shoulder in the distribution of TCM syndromes,expand the contents of TCM visit,and provide a reference for TCM syndrome differentiation of periarthritis of shoulder,so as to carry out TCM syndrome differentiation and treatment more accurately and efficiently.1 Research ObjectivesTo observe the soft tissue pathological changes of periarthritis of shoulder under musculoskeletal ultrasound.To explore the correlation between the image characteristics of periarthritis of shoulder with musculoskeletal ultrasound and the symptoms of traditional Chinese medicine,increase the content of musculoskeletal ultrasound image in the inspection,expand the scope of inspection,and provide reference for the symptomatic treatment of periarthritis of shoulder with traditional Chinese medicine.2 Research MethodsA total of 60 patients with periarthritis of shoulder who were admitted to Wangling Hospital from January 2020 to January 2021 for outpatient treatment and general department of bone injuries were selected.The general information of the patients(gender,age),the left and right sides of the affected shoulder,and the onset time were sorted and recorded.The Chinese medicine physician with the title of deputy director or above was asked for consultation,and the Chinese medicine syndrome differentiation classification scale of periarthritis of shoulder was filled in.The Chinese medicine syndrome differentiation was carried out,and the ultrasonic examination was carried out by the ultrasonic physician after syndrome differentiation.Musculoskeletal ultrasound examination method:The examinees used Sonimage HS1 color ultrasound apparatus and C5-2 high-resolution arc array probe.The shoulder muscles and joint capsule were examined successively according to the shoulder ultrasonic examination guide.The imaging manifestations of the affected shoulder and the healthy shoulder under ultraound were compared and observed.The effusion around the long head tendon of the biceps brachii of the affected shoulder was recorded,and the maximum depth of effusion was measured,expressed in millimeters(mm).The calcification spots of supraspinatus,infraspinatus and subscapularis were recorded.The thickness of the gliding bursa of the deltoid muscle is expressed in mm.Constant-Murly shoulder function score was performed,and SPSS 20.0 was used for statistical analysis.3 Research ResultsThe mean age of the 60 patients was(59.62±8.9)years old,and the median was 58.00 years old.There were 37 female patients(61.67%);The mean course of disease was(3.62±1.56)months,and the median was 3.00 months.The TCM syndromes were wind-cold and dampness type in 22 cases(36.67%),qi stagnation and blood stasis type in 20 cases(33.33%),and qi and blood deficiency type in 18 cases(30.00%).There were statistical differences in age,disease course distribution and shoulder joint function scores among patients with different TCM syndromes(P<0.05),there was no statistically significant difference between different syndromes(P=0.87>0.05).Patients with different syndromes had statistical difference in the presence or absence of effusion around the long head tendon of biceps brachii(P<0.001),there was statistically significant difference in the presence or absence of calcification of supraspinatus tendon(P<0.001),the subscapularis tendon calcification was statistically significant(P<0.001),and there was no statistical difference in the presence of effusion in the deltoid glide bursa among different syndromes(P=0.86>;0.05),whether the bursa thickness is>There was statistically significant difference at 2mm(P&L;0.001).Logistic regression analysis showed that:The effusion around the biceps longiceps tendon was positively correlated with the syndrome of wind-cold and dampness(OR=16.993,P=0.0084),the bursal thickness?2mm was positively correlated with the syndrome of wind-cold and dampness(OR=3.778,P=0.0277),and the pain score?20 was positively correlated with the syndrome of wind-cold and dampness(OR=2.945,P=0.0277).P=0.0529),daily life score?20 was positively correlated with wind-cold and dampness type syndrome(OR=11.045,P=0.0003),and range of motion score ?20 was positively correlated with wind-cold and dampness type syndrome(OR=3.778,P=0.0277).The calcification of supraspinatus tendon was positively correlated with the type of qi stagnation and blood stasis(OR=35.286,P<0.001),subscapularis tendon calcification was positively correlated with the type of qi stagnation and blood stasis(OR=9.444,P=0.0015),bursa thickness ?2mm was positively correlated with the type of qi stagnation and blood stasis(OR=3.000,P=0.0096).Pain score?20 was positively correlated with Qi-blood deficiency syndrome(OR=3.929,P=0.0208).Peripheral effusion of biceps tendon was negatively correlated with Qi-blood deficiency type syndrome(OR=0.188,P=0.0067),and bursa thickness?2mm was negatively correlated with Qi-blood deficiency type syndrome(OR=0.063,P=0.0001).4 ConclusionBy observing the imaging manifestations of periarthritis of shoulder under muscul oskeletal ultrasound,the correlation between periarthritis of shoulder and TCM syndro mes was explored,and it was found that there were differences in the imaging manife stations of periarthritis of shoulder under musculoskeletal ultrasound in patients with di fferent TCM syndromes:The hydrops around the long head tendon of biceps brachii is an important feature of the syndrome of wind cold and dampness in ultrasonic diagn osis.The calcification of the tendon of supraspinatus muscle and subscapularis muscle as well as the bursa thickness?2mm are important features of the syndrome of qi st agnation and blood stasis in ultrasonic diagnosis.Patients with qi and blood deficiency have no specificity under ultrasonic diagnosis. |
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