Ultrasonographic and clinical study of post-stroke painful hemiplegic shoulder

Aim of the work: To describe the structural abnormalities of the painful hemiplegic shoulder (PHS) by ultrasound (U/S) and their relationship with some clinical variables. Materials and methods: Eighty consecutive patients with post-stroke PHS were subjected to both clinical assessment and ultrasonographic examination of both shoulders. Ultrasonographic imaging data were classified into five grades. Results: The biceps tendon sheath effusion (51.25%) and the SA-SD bursitis (43.75%) were the most frequent abnormalities in the affected painful shoulder. No significant relationship (P = 0.114) was found between the U/S grades of the painful hemiplegic shoulder and the Brunnstrom motor recovery stages. Ultrasonographic grades of the unaffected shoulder were significantly correlated with the stroke duration (P < 0.001), the Brief Pain Inventory score (P < 0.05), shoulder pain duration (P < 0.001), and degree of spasticity (P < 0.001). Conclusion: Ultrasonography is an essential method in evaluation of post-stroke PHS. However, the U/S grades were not correlated with the stages of motor recovery. Avoiding overuse of the unaffected shoulder will be helpful for prevention of shoulder injuries following hemiplegic stroke. (C) 2014 The Egyptian Society of Radiology and Nuclear Medicine. Production and hosting by Elsevier B.V.