Ultrasonographic and clinical study of post-stroke painful hemiplegic shoulder

Abstract

Aim of the work: To describe the structural abnormalities of the painful hemiplegic shoulder (PHS) by ultrasound (U/S) and their relationship with some clinical variables. Materials and methods: Eighty consecutive patients with post-stroke PHS were subjected to both clinical assessment and ultrasonographic examination of both shoulders. Ultrasonographic imaging data were classified into five grades. Results: The biceps tendon sheath effusion (51.25%) and the SA–SD bursitis (43.75%) were the most frequent abnormalities in the affected painful shoulder. No significant relationship (P = 0.114) was found between the U/S grades of the painful hemiplegic shoulder and the Brunnstrom motor recovery stages. Ultrasonographic grades of the unaffected shoulder were significantly correlated with the stroke duration (P < 0.001), the Brief Pain Inventory score (P < 0.05), shoulder pain duration (P < 0.001), and degree of spasticity (P < 0.001). Conclusion: Ultrasonography is an essential method in evaluation of post-stroke PHS. However, the U/S grades were not correlated with the stages of motor recovery. Avoiding overuse of the unaffected shoulder will be helpful for prevention of shoulder injuries following hemiplegic stroke.

Keywords

• Ultrasound
• Stroke
• Pain
• Shoulder