The diagnosis and prognosis of impingement syndrome in the shoulder with using quantitative SPECT assessment: a prospective study of 73 patients and 24 volunteers

Abstract

Background: Diagnosing impingement syndrome without rotator cuff tear usually depends on the physical examination and roentgenography, and obtaining objective evidence for this condition is at best difficult. The purpose of this study was to ascertain whether quantitatively assessing this condition with using single photon emission computerized tomography (SPECT) can diagnose impingement syndrome and predict the postoperative results.

Methods: Before executing arthroscopic or open treatment, SPECT was performed on 73 patients and 24 volunteers and these people were followed up for 2 years. Any increased uptake on SPECT was investigated by using the axial view, which demonstrated the greatest uptake for the acromion, distal clavicle, greater tuberosity, lesser tuberosity and the coracoid process of the operated and non-operated sides.

Results: The patients who were diagnosed as having impingement syndrome with or without rotator cuff tear showed increased uptake on the operative side compared to the non-operated side in the assessed locations. The greater tuberosity of the humerus could be used for quantitative measurement as a postoperative prognostic factor.

Conclusions: The bone SPECT method is useful for making the diagnosis of patients with impingement syndrome, and the results of quantitative assessment at the greater tuberosity can be used for evaluating the prognosis following the operation.

Keywords: Diagnosis; Prognosis; SPECT; Shoulder impingement syndrome.

Fig. 1

Increased uptake in single photon emission computerized tomography investigated using an axial view with a 1 × 1 square in acromion (A), distal clavicle (B), coracoid process (C), and greater tuberosity (D). The greatest difference between the operative and non-operative side was seen on acromion.