Published online Jul 26, 2020. doi: 10.12998/wjcc.v8.i14.2977
Peer-review started: April 1, 2020
First decision: April 22, 2020
Revised: April 24, 2020
Accepted: July 4, 2020
Article in press: July 4, 2020
Published online: July 26, 2020
The symptoms of supraspinatus tendinitis are usually relieved after treatment, but its recurrence is common. One of the reasons for recurrence is the lack of objective curative measures. The visual analogue scale (VAS) and Constant-Murley score (CMS) are used to evaluate the pain and function of the shoulder by the patient’s complaint and physical examination. Due to the strong subjectivity, the accurate assessment of treatment efficacy and disease prognosis is limited.
The muscle stiffness of supraspinatus tendinitis will change correspondingly at different pathological stages. Shear wave elastography (SWE) can quantitatively analyze the tissue elasticity in the targeted region of interest by measuring the Young’s modulus (YM) value. At present, it is generally believed that the tissue elasticity of the supraspinatus muscle should gradually return to a normal state after systemic treatment. Therefore, SWE is may be used for the evaluation of the therapeutic effect of the supraspinatus tendinitis.
In this study, we evaluated the improvement of pain and joint activity during treatment by VAS and CMS. We performed a SWE test and recorded the YM value of supraspinatus tendinitis. The aim of our study was to investigate the role of SWE in evaluating the diagnosis and treatment outcome of supraspinatus tendinitis.
A total of 87 patients with supraspinatus tendinitis were recruited in this study, while 30 healthy volunteers were enrolled as the control group. VAS and CMS were used for the detection of shoulder pain and function. SWE was performed, and the YM value of the supraspinatus for each patient was recorded. By comparing the differences in YM values between supraspinatus tendinitis and healthy volunteers, we explored the role of the YM value in the diagnosis of supraspinatus tendinitis. After treatment, the patients who achieved significantly effective and cured were grouped. The patients in the continued treatment group continued to receive treatment according to the YM value, and the remaining patients who stopped receiving treatment were included in the stopped treatment group. All patients were followed up for 1 year, and the difference in recurrence rate between the two groups was compared.
This study revealed that the pretreatment YM value of patients with supraspinatus tendinitis was positively correlated with VAS (r = 0.564) and negatively correlated with CMS (r = -0.411), indicating that the YM value can also be used to evaluate the severity of supraspinatus tendinitis. The degree of change of the YM value, VAS and CMS during the treatment of supraspinatus tendinitis were analyzed. It suggested that the YM value was more objective than VAS and CMS. The cumulative recurrence free rate in the continued treatment group (91.43%) was significantly higher than that of the stopped treatment group (64.71%). It indicated that the treatment according to the YM value was more thorough and the recurrence rate was lower.
Compared with VAS and CMS, the YM value of SWE can more objectively and accurately evaluate the severity and therapeutic effect of supraspinatus tendinitis. It is more valuable in the management of supinastomy tendinitis.
The YM value is contributed to reducing the recurrence rate of supraspinatus tendinitis. However, the YM value is affected by a series of factors such as physical fitness, labor strength, age, etc. In order to assess the YM value more accurately, future studies to more accurately match the general data of different groups are planned. Therefore, the specified assessment is expected to be implemented in a future study.