無症候性腱板断裂は炎症を合併しない－骨シンチグラフィーによる 無症候性断裂と症候性断裂との比較

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Hypothesis: Many rotator cuff tears (RCTs) are asymptomatic. In contrast, RCTs encountered in clinical settings are symptomatic. One cause of pain may be inflammation associated with symptomatic RCTs. Our hypothesis was that shoulders with a symptomatic RCT exhibit increased radioisotope (RI) uptake as an indicator of inflammation while those with an asymptomatic RCT show no increase in RI uptake. Methods: After bone scintigraphy, ultrasonography was performed on 140 shoulder joints of 70 patients without shoulder pain to diagnose the presence of a RCT. RI uptake of shoulder joints were measured and reported as standardized relative intensities. Shoulder joints without a RCT and 28 shoulders from 28 patients with a symptomatic RCT (14 men, 14 women; mean age, 62years old) were served as controls. Results: Of the 140 shoulder joints, we diagnosed asymptomatic RCTs in 34 joints from 26 patients (10 men, 16 women; mean age, 72 years old) and no tear in 32 joints from 20 patients (10 men, 10 women; mean age, 59 years old). RI uptake in the asymptomatic RCT group was comparable to that in the no RCT group (1.7 [0.3] vs. 1.7 [0.4], non-significant). A significant increase in RI uptake occurred only in the symptomatic RCT group (2.2 [0.4], P<0.05). Discussion: RI uptake did not increase in shoulder joints with asymptomatic rotator cuff tears. Our results support the claim that the inflammation is one of the causes of pain associated with symptomatic RCTs. Shoulder pain associated with RCT may be managed effectively by controlling inflammation.

無症候性腱板断裂は炎症を合併しない－骨シンチグラフィーによる<BR>無症候性断裂と症候性断裂との比較

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