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. 2022 Nov;45(6):916-929.
doi: 10.1080/10790268.2021.1881238. Epub 2021 Feb 22.

MRI evaluation of shoulder pathologies in wheelchair users with spinal cord injury and the relation to shoulder pain

Ursina Arnet  1   2 , Wiebe H de Vries  1   2 , Inge Eriks-Hoogland  3 , Christian Wisianowsky  3 , Lucas H V van der Woude  4   5 , DirkJan H E J Veeger  6   7 , Markus Berger  1 ; SwiSCI Study Group
Affiliations

MRI evaluation of shoulder pathologies in wheelchair users with spinal cord injury and the relation to shoulder pain

Ursina Arnet et al. J Spinal Cord Med. 2022 Nov.

Abstract

Objective: To describe the number, specifics and co-occurrence of shoulder pathologies detected by MRI in manual wheelchair users with spinal cord injury and to evaluate the association between shoulder pathologies and presence of shoulder pain.

Design: Cross-sectional observation study.

Setting: Community.

Participants: Fifty-one wheelchair-dependent persons with spinal cord injury (44 males, 7 females, median age 50 years (IQR 14), median time since injury 24 years (IQR 16)) were allocated to pain or no-pain group based on the Wheelchair User Shoulder Pain Index.

Interventions: Not applicable.

Outcome measures: All persons underwent shoulder MRI. Pathologies were scored blinded by two experienced radiologists. Participant characteristics, number and severity of shoulder pathologies were analyzed descriptively. Logistic regression was performed to evaluate the association between MRI findings and shoulder pain.

Results: The median number of co-occurring MRI findings per person ranged from 0 to 19 (out of 31 possible findings). The cluster of MRI findings occurring most often together were tendon tears of supraspinatus (present in 84%), subscapularis (69%) and biceps (67%) and osteoarthritis of acromioclavicular joint (80%). When correcting for age and time since injury, the logistic regression showed no statistically significant correlation between the individual pathologies and shoulder pain.

Conclusion: MRI findings of shoulder pathology are very frequent in persons with and without shoulder pain. Therefore, when diagnosing the cause of shoulder pain and planning interventions, health care professionals should keep this finding in mind and MRI should not be interpreted without careful consideration of clinical history and functional testing.

Keywords: Rotator cuff tear; Shoulder pain; Shoulder pathology.

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Conflict of interest statement

Contributors: Study design: CW, DV, LvdW, MB, UA; data analysis: CW, MB, UA, WdV; data interpretation: all authors; manuscript drafting: UA; manuscript revision: all authors; approval of final version of submitted manuscript: all authors.

No potential conflict of interest was reported by the author(s).

Figures

Figure 1
Figure 1
Clustering of MRI findings in the pain and the no pain group. The lower the dissimilarity measure the better the MRI findings are clustered. Numbers in brackets represent the number of MRI findings present in the according group.
Figure 2
Figure 2
Number of MRI findings and related shoulder pain assessed with the performance corrected wheelchair user shoulder pain index (PC-WUSPI, 0-150).
Figure 3
Figure 3
Percentage of present shoulder pathologies in the pain and the no pain group and the corresponding severity. Tendon calci = tendon calcification, arthr = joint arthritis, calci = bursa calcification.
See this image and copyright information in PMC

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