Correlation Between Musculoskeletal Ultrasound Findings And Clinical Staging And Symptoms Of Frozen Shoulder

Objective:By observing the musculoskeletal ultrasonographic findings of frozen shoulder in different clinical stages,(1)to explore the correlation between musculoskeletal ultrasonographic findings and frozen shoulder clinical stages,(2)to explore the correlation between musculoskeletal ultrasonographic findings and frozen shoulder symptoms.Methods:The data of frozen shoulder patients who met the inclusion and exclusion criteria,and went to the outpatient clinic of rehabilitation department of Shanxi Bethune Hospital,or recruited by society from 2022.03 to 2023.01 were collected.The data included name,sex,age,height,weight,affected side,course of disease,visual analog score of pain(VAS),range of motion of the affected shoulder and Constant-Murley shoulder score(CMS).They were divided into 3 groups according to clinical stage.The glenohumeral distance(GHD),posterior shoulder capsule thickness(PCT),coracobrachial ligament thickness(CHL),joint capsule and supraspinatus muscle shear wave elastography(SWE),blood flow in rotator interval(RI)of the affected shouder were measured by the same physician with more than 5 years’ experience under musculoskeletal ultrasound.The differences of shoulder ultrasonographic findings among the three groups were compared,and the correlation between ultrasonic findings and symptoms was observed.Results:(1)There was no significant difference in sex,age,body mass index(BMI),affected side,VAS rest,CHL,supraspinatus and joint capsule SWE among the three clinical stages of frozen shoulder.(2)There was no significant difference in the course of disease between stage 1 group and stage 2 group,but there was significant difference between stage 1 group and stage 3 group,stage 2 group and stage 3 group.There were significant differences in VAS activity,VAS sleep,flexion,abduction,external rotation,internal rotation and CMS among different stages.(3)GHD,PCT and the positive ratio of RI blood flow was significantly different in different stages,in which the GHD of stage 1 was the highest,and the PCT of stage 2 was the highest.There was a significant difference in the positive ratio of RI blood flow between stage 1 and stage 2,stage 1 and stage 3,but there was no significant difference between stage 2 and period 3.(4)GHD and PCT on different stages were statistically significant.The larger the GHD value,the more inclined to clinical stage 1.The larger the PCT value,the more inclined to clinical stage 2.(5)There was a positive correlation between flexion,abduction activity and GHD,and a negative correlation with PCT.There were significant differences in VAS activity and VAS sleep among different RI blood flow groups,and the scores of VAS activity and VAS sleep in RI blood flow positive group were higher than those in negative group.Conclusion:(1)Musculoskeletal ultrasound scan of RI blood flow,glenohumeral distance,posterior shoulder joint capsule thickness is helpful to judge the clinical stage of frozen shoulder.(2)The blood flow of RI,glenohumeral distance and the thickness of posterior articular capsule under musculoskeletal ultrasound are related to the clinical symptoms of frozen shoulder,which may be used as an intervention point to relieve the symptoms.