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. 2005 Mar 15;35(4):192-7.
doi: 10.1157/13072589.

[Evolution and characteristics of primary care patients with painful shoulder]

[Article in Spanish]
M F García Díaz  1 , M Medina Sánchez
Affiliations

[Evolution and characteristics of primary care patients with painful shoulder]

[Article in Spanish]
M F García Díaz et al. Aten Primaria. .

Abstract
in English, Spanish

Objectives: To describe the population attending teaching health centres in Area V, Asturias, to consult for painful shoulder. To describe the examination, diagnosis, treatment and clinical response.

Design: Longitudinal, descriptive study.

Setting: Teaching health centres in Area V, Asturias.

Participants: Patients consulting because of pain in their shoulders in October and November 2002.

Main measurements: Two measurements, the first of which in December 2002 appraised age, sex, job, time off work, arc of pain, flection, internal-external rotation, and diagnostic impression. The second, in May 2003, assessed evolution, x-rays, echography, medication, infiltration, physiotherapy, exercises at home, referral to specialist, and final diagnosis. Bivariant and kappa index descriptive analyses were run.

Results: 110 cases, 58.2% women and 41.8% men, with an average age of 57 (95% CI, 54.17-59.79), were included. 52.7% were retired; no particular job predominated; 7.3% were off work; 30% had had no examination of arc of movement; 70% evolved satisfactorily. The most common diagnosis was cuff tendinitis, with initial and final diagnosis coinciding well. 77.4% of patients took NSAIDs; 16% were infiltrated; 32.1% did physiotherapy; and 36.8%, exercises at home. 65.1% had no x-ray and only 6.6% had echographies, all of which found something. There was no statistically significant relationship between medication or infiltration and favourable evolution; and there was, between physiotherapy or exercises and favourable evolution.

Conclusions: Most patients were middle-aged, women, pensioners, and had little time off work. Two-thirds evolved well. Examinations were incomplete and few complementary tests were run.

Objetivo: Describir el tipo de población que consulta por hombro doloroso en atención primaria en Asturias. Describir la exploración, el diagnóstico, los tratamientos utilizados y la respuesta clínica.

Diseño: Estudio descriptivo, longitudinal.

Emplazamiento: Centros de salud docentes del Área V de Asturias.

Participantes: Pacientes que consultaron por dolor de hombro en octubre y noviembre de 2002.

Mediciones principales: Características de los pacientes: edad, sexo, profesión, baja laboral, arco doloroso, flexión, rotación internaexterna e impresión diagnóstica. A los 5 meses se registraron los datos sobre su evolución, radiografías, ecografías, fármacos, infiltraciones, fisioterapia, ejercicios en el domicilio, derivación especializada y diagnóstico final.

Resultados: Se recogieron 110 casos (58,2%, mujeres y 41,8%, varones), con una media de edad de 57 años (intervalo de confianza [IC] del 95%, 54,17-59,79). El 52,7% estaba jubilado. El 7,3% se encontraba en situación de baja laboral. En un 30% no se disponía de la exploración de ningún arco de movimiento. El 70% de los pacientes evolucionó satisfactoriamente. El diagnóstico más frecuente fue la tendinitis de manguito, y la concordancia entre los diagnósticos inicial y final fue buena. Un 77,4% tomó antiinflamatorios no esteroideos (AINE). El 16% recibió infiltraciones.Un 32,1% realizó fisioterapia y un 36,8%, ejercicios en el domicilio. En el 65,1% de los pacientes no se hizo ninguna radiografía y sólo se efectuó una ecografía en el 6,6%. La evolución favorable no se asoció estadísticamente con los fármacos o la infiltración, y sí con la fisioterapia y los ejercicios.

Conclusiones: La mayoría de pacientes con hombro doloroso son mujeres, de mediana edad y pensionistas. Más del 60% evoluciona satisfactoriamente. La exploración realizada suele ser incompleta y con pocas pruebas complementarias.

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References

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