腱板全層断裂に対する保存的治療におけるMRIの経時的変化

概要

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Background: The purpose of this study is to compare MRI findings before and after non-operative treatment in patients with full-thickness tear of the rotator cuff. Methods: Eighteen patients with an average age of 64 years old were enrolled into the study. The non-operative treatment consisted of rehabilitation and injection of a steroid into the subacromial bursa. The average JOA score improved significantly from 67 to 88 points. The average interval between the MRI examinations was 13 months. The intraarticular fluid collection was assessed at the positions of subacromial bursa (SAB), gleno-humeral joint (GHJ), subcoracoid bursa (SCB), and sheath of long head of biceps tendon (LHBS) and graded. The relationships between improvement of MRI findings, age, tear size, intra-MRI interval, pain score and ROM were evaluated retrospectively. Results: There were 13 patients with no changes in MRI findings before and after the treatment. The other 5 patients improved in SAB, GT, and LHBS fluid collection grades, although the improvement was not found in SCB. These 5 patients were significantly older and needed more than 12 months of treatment. Conclusion: The improvement of symptoms was not directly associated with the MRI findings. Fluid collection in the SCB did not improved in all patients. The improvement in MRI findings was suspected to take more than 12 months after the beginning of the treatment.