Ultrasound doppler signal may help in assessing shoulder complaints in elderly: Study

Portugal: A recent study in the journal Frontiers in Medicine has shown that the calcification diameters of 6 mm or greater are connected with shoulder discomfort in people under the age of 56. In elderly patients, a distance of 6 mm or greater from the calcification to the tendon insertion is associated with discomfort. Doppler signal is also linked to shoulder discomfort. The existence of symptoms is strongly associated with an algorithm based on a set of precise ultrasonographic criteria. 

The shoulder is one of the most prevalent anatomical locations for musculoskeletal discomfort, with a female predominance. The most common intrinsic shoulder diseases are calcific tendinitis and other rotator cuffs (RC) abnormalities. 

João Janeiro and the team conducted this study with the objective to detect ultrasound (US) characteristics that are related to the existence of shoulder problems. This was observational, case-control research that aimed to compare findings in the United States between participants with and without shoulder discomfort. Data was collected and recorded anonymously between February 2018 and June 2020.

Patients with shoulder discomfort aged 18–70 years old who were referred for unilateral shoulder US at our hospital radiology department were recruited in a systematic manner until a total of 140 cases were included. Controls were chosen at random and encouraged to participate willingly. Fisher's and Mann-Whitney U-tests were employed, with p-values less than 0.05 deemed significant.

A total of 202 people were included in the study, with 140 cases and 62 controls. Only symptomatic shoulders had a calcification size of 6 mm and a distance to tendon insertion of 6 mm around age 56. In the presence of symptoms, color Doppler in the rotator cuff (RC) tendons predominated. In this research population, an algorithm combining the number of calcifications, tendon echotexture and insertional thickening, osseous irregularity, cuff tears, and subacromial effusion had a 92 percent (57/62) specificity for shoulder pain.

Finally, calcifications having a diameter of 6 mm or greater in individuals less than 56 years old, or a distance from tendon insertion of 6 mm or greater in older patients, are related with discomfort. The existence of any Doppler signal is also linked to shoulder pain. An algorithm based on a collection of particular, but less common, US criteria shows a substantial correlation with the occurrence of symptoms.

Reference:

JJaneiro, J., Barreira, S. C., Martins, P., Ninitas, P., Campos, J., & Fonseca, J. E. (2021). Ultrasound Features Associated With Shoulder Complaints: Calcifications Larger Than 6 mm in Young Patients and Positive Doppler Are Associated With Pain. In Frontiers in Medicine (Vol. 8). Frontiers Media SA. https://doi.org/10.3389/fmed.2021.715423