Magnetic Resonance Arthrographic Findings of the Painful Hemiplegic Shoulder

Hong, Jin Young; Jun, Po Sung; Son, Young Geun; Choi, Hyun Wook; Lee, Ji Heoung; Kang, Seung Hoon; Kim, In Taek

Abstract

OBJECTIVE
To identify the etiology of hemiplegic shoulder pain by magnetic resonance (MR) arthrography. METHOD: The study included seventy-four hemiplegic patients with shoulder pain. After several physical examinations, all patients had fluoroscopically guided injection by a physiatrist with a maximum of 12~15 ml of contrast agent. Then T1-weighted, T2-weighted and fat-suppressed T1-weighted images were taken at the oblique coronal plane. In addition, fat-suppressed T1-weighted images were obtained at the oblique sagittal and oblique coronal plane.
RESULTS
Except for the 9 patients who did not finish the study, the mean age of the participants was 61.5+/-8.9 years and mean duration of the cerebrovascular accident (CVA) was 15.7+/-9.7 weeks. The findings were as follows: 40% supraspinatus tendinitis, 30.8% superior labrum anterior to posterior (SLAP) lesion, 29.2% adhesive capsulitis, 24.6% supraspinatus partial tear, 23.1% biceps tendinitis, 13.8% supraspinatus full thickness tear, 7.7% infraspinatus partial tear. The SLAP lesion had significant statistic relationship with biceps tendinitis (p<0.05) but not with rotator cuff lesion.
CONCLUSION
We found that causes of hemiplegic shoulder pain were various. The prevalence of the SLAP lesion was high (30.8%). We recommend the MR arthrography when the hemiplegic shoulder pain does not improve by conventional therapy or the cause of the pain is uncertain.