Dataset Information

What Imaging-Detected Pathologies Are Associated With Shoulder Symptoms and Their Persistence? A Systematic Literature Review.

ABSTRACT:

Objective

Shoulder symptoms are common, and imaging is being increasingly used to help with management. However, the relationship between imaging and symptoms remains unclear. This review aims to understand the relationship between imaging-detected pathologies, symptoms, and their persistence.

Methods

A systematic review using Medline, EMBASE, Cochrane, and grey literature was conducted to April 2017. The cross-sectional and longitudinal relationships between imaging-detected abnormalities and symptoms were analyzed and associations qualitatively characterized by a best-evidence synthesis based on study design, covariate adjustment, and the Grade of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. Modalities included ultrasound, magnetic resonance imaging (MRI), radiographs, positron emission tomography (PET), bone scintigraphy, and computed tomography.

Results

A total of 6,569 abstracts was screened and 56 articles were included. In total, 50 studies did not adjust for covariates and 36 analyzed individual pathologies only. The majority of studies showed conflicting results. There was no significant association between most imaging features and symptoms among high-quality, cross-sectional studies. There was low-quality evidence that enhancement of the joint capsule on MRI and increased uptake on PET were associated with symptoms in adhesive capsulitis. Based on high-quality longitudinal studies, enlarging rotator cuff tears were associated with an increased incidence of symptoms.

Conclusion

There were conflicting results on the association of imaging features with shoulder symptoms and their persistence. The existing evidence was very low in quality, based on the GRADE methodology. Further high-quality studies are required to understand the relationship between imaging and shoulder symptoms and to determine the appropriate role of imaging in care pathways.

SUBMITTER: Tran G

PROVIDER: S-EPMC6099421 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature

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Publications

What Imaging-Detected Pathologies Are Associated With Shoulder Symptoms and Their Persistence? A Systematic Literature Review.

Tran Gui G Cowling Paul P Smith Toby T Bury Julie J Lucas Adam A Barr Andrew A Kingsbury Sarah R SR Conaghan Philip G PG

Arthritis care & research 20180606 8

<h4>Objective</h4>Shoulder symptoms are common, and imaging is being increasingly used to help with management. However, the relationship between imaging and symptoms remains unclear. This review aims to understand the relationship between imaging-detected pathologies, symptoms, and their persistence.<h4>Methods</h4>A systematic review using Medline, EMBASE, Cochrane, and grey literature was conducted to April 2017. The cross-sectional and longitudinal relationships between imaging-detected abno ...[more]

PMID: 29513925

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Project description:BackgroundWave surfing will debut in the next Olympic Games and is increasingly popular as a sport. Chronic shoulder complaints are frequently reported amongst surfers, though literature researching its pathophysiology and prevention is scarce. This article provides an overview of the current literature, proposes a potential pathogenesis and a potential physiotherapeutic prevention program for surf-induced shoulder complaints.MethodsA systematic review was performed considering the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for articles regarding kinematic analysis of the surf paddling movement. Data sources were Embase, MEDLINE (PubMed) and Research gate. We included case series and cohort studies that originally studied or described the paddle movement made by wave surfers, studies that reported on kinesiologic analysis with nerve conduction studies and studies on 3D motion analysis of the shoulder while paddling.ResultsEight original articles were included that analysed the shoulder movement in paddling surfers. Muscles that are active during paddling are mainly internal rotators and muscles that are involved in shoulder flexion. Internal rotators are active in propelling the surfer through the water, though external rotator strength is only used while the arm is out of the water.DiscussionIn surfers with shoulder complaints, external rotation range of motion and external rotation strength are impaired. Scapulothoracic dyskinesis may occur and subacromial pain syndrome may coincide. Further research should address potential pectoralis minor shortening, which may lead to aberrant scapular tilt and lateral rotation of the scapula. The surfer's shoulder is characterised by external rotation deficit, as opposed to internal rotation deficit in the thrower's shoulder, and it differs substantially from shoulder complaints in swimmers. Therefore, a specific prevention or rehabilitation protocol for surfers is required. Decreased thoracic extension may thereby alter the risk of scapular dyskinesis and hence increase the risk of impingement around the shoulder joint. A potential physiotherapeutic prevention programme should address all these aspects, with the main goal being to increase external rotator strength and to stretch the internal rotators.ConclusionThere is a high incidence of chronic surf-induced shoulder complaints in surfers. Symptoms may arise due to imbalanced training or scapular dyskinesis, which may subsequently trigger subacromial pain. Physiotherapeutic prevention should include stretching of the internal rotators, external rotator training and optimisation of thoracic extension and scapulothoracic movement.

Dataset Information

What Imaging-Detected Pathologies Are Associated With Shoulder Symptoms and Their Persistence? A Systematic Literature Review.

Objective

Methods

Results

Conclusion

Publications

What Imaging-Detected Pathologies Are Associated With Shoulder Symptoms and Their Persistence? A Systematic Literature Review.

Similar Datasets

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