Acromion Types and Role of Corticosteroid with Shoulder Impingement Syndrome.

Abstract

OBJECTIVE:

To determine the association between shoulder impingement and morphological characteristics of acromion and the role of sub-acromial injection of methylprednisolone in the short-term treatment for relieving pain and improve functional disability of these patients.

STUDY DESIGN:

A descriptive study.

PLACE AND DURATION OF STUDY:

Department of Orthopedic Surgery and Traumatology Unit-I (DOST-I), Mayo Hospital, Lahore, between November 2013 to June 2014.

METHODOLOGY:

All patients presented in OPD with shoulder pain were included as subjects and evaluated by clinical test and categorised using X-ray scapula Y-view. Patients with impingement syndrome were correlated with Bigliani types and offered intra-lesional injection into sub-acromial space with 2ml of xylocaine 2% and 40 mg of methylprednisolone using 22 gauge needle. The effectiveness was assessed in terms of relieving pain and good functional outcomes; and rotator cuff tear was clinically assessed among impingement positive patient. The pain was assessed using visual analogue score before and after the administration of the injection. Demographic variables for frequencies and their associations were analysed using SPSS version 20.0. Significance level was p <0.05.

RESULTS:

Among the 101 cases, there was no case of tear of rotator cuff tendon on clinical assessment. Majority of the patients (58.4%) were females with mean age of 31.38 ±1.13 years. Majority 57 (56.4%) of the patients had acromion type II (curved), which was the most common cause of shoulder impingement. Most had moderate pain. Thirty-four patients required intralesional steroid, which relieved the pain in 31 of them.

CONCLUSION:

Shoulder impingement syndrome without tear of rotator cuff tendon was found in younger age group between 40 to 45 years, which was relieved by intralesional corticosteroid administration. These patients had type II (curved) acromion, according to Bigliani classification.

• Authors: Muhammad Akram, Syed Faraz Ul Hassan Shah Gillani, Faheem Mubashir Farooqi, Syed Muhammad Awais
• Journal: Journal of the College of Physicians and Surgeons--Pakistan : JCPSP (J Coll Physicians Surg Pak) Vol. 26 Issue 12 Pg. 980-983 (Dec 2016) ISSN: 1681-7168 [Electronic] Pakistan
• PMID: 28043311 (Publication Type: Journal Article)

Chemical References

• Anesthetics, Local
• Glucocorticoids
• Lidocaine
• Methylprednisolone

Topics

• Acromion (injuries)
• Adult
• Aged
• Anesthetics, Local (administration & dosage)
• Female
• Fractures, Bone
• Glucocorticoids (administration & dosage)
• Humans
• Injections, Intralesional
• Lidocaine (administration & dosage)
• Male
• Methylprednisolone (administration & dosage)
• Middle Aged
• Recovery of Function
• Shoulder Impingement Syndrome (diagnostic imaging, drug therapy)
• Shoulder Pain (etiology)
• Trauma Severity Indices
• Treatment Outcome