Shoulder magnetic resonance imaging findings in manual wheelchair users with spinal cord injury

Objective: To investigate the prevalence of rotator cuff and long head of the biceps pathologies in manual wheelchair (MWC) users with spinal cord injury (SCI). Design: Cross-sectional study. Setting: Outpatient clinic at a tertiary medical center. Participants: Forty-four adult MWC users with SCI (36 men and 8 women) with an average age (SD) of 42 (13) years. SCI levels ranged from C6 to L1; complete and incomplete SCI. Outcome Measures: Participants’ demographic and anthropometric information, presence of shoulder pain, Wheelchair User’s Pain Index (WUSPI) scores, and magnetic resonance imaging findings of shoulder pathologies including tendinopathy, tendon tears, and muscle atrophy. Results: Fifty-nine percent of the participants reported some shoulder pain. The prevalence of any tendinopathy across the rotator cuff and the long head of biceps tendon was 98%. The prevalence of tendinopathy in the supraspinatus was 86%, infraspinatus was 91%, subscapularis was 75%, and biceps was 57%. The majority of tendinopathies had mild or moderate severity. The prevalence of any tears was 68%. The prevalence of tendon tears in the supraspinatus was 48%, infraspinatus was 36%, subscapularis was 43%, and biceps was 12%. The majority of the tears were partial-thickness tears. Participants without tendon tears were significantly younger (P Conclusion: Mild and moderate shoulder tendinopathy and partial-thickness tendon tears were highly prevalent in MWC users with SCI. Additionally, the findings of this study suggest that strategies for monitoring shoulder pathologies in this population should not be overly reliant on patient-reported pain, but perhaps more concerned with years of wheelchair use and age.研究目的：探讨脊髓损伤（spinal cord injury, SCI）手动轮椅（manual wheelchair, MWC）使用者的肩袖及肱二头肌长头病变患病率。 研究设计：横断面研究。 研究地点：某三级医疗中心门诊诊所。 研究对象：44名成年脊髓损伤手动轮椅使用者，其中男性36名、女性8名，平均年龄（标准差）为42（13）岁；脊髓损伤节段范围为C6至L1，涵盖完全性与不完全性脊髓损伤。 结局指标：收集受试者的人口统计学及人体测量学资料、肩部疼痛发生情况、轮椅使用者疼痛指数（Wheelchair User’s Pain Index, WUSPI）评分，以及肩袖与肱二头肌长头相关病变（包括肌腱病、肌腱撕裂及肌肉萎缩）的磁共振成像（magnetic resonance imaging, MRI）表现。 研究结果：59%的受试者自述存在肩部疼痛。肩袖及肱二头肌长头肌腱的任意肌腱病患病率为98%；其中冈上肌腱病患病率为86%，冈下肌腱病为91%，肩胛下肌腱病为75%，肱二头肌腱病为57%，多数肌腱病为轻度或中度严重程度。任意肌腱撕裂的患病率为68%；冈上肌腱撕裂患病率为48%，冈下肌腱撕裂为36%，肩胛下肌腱撕裂为43%，肱二头肌腱撕裂为12%，多数撕裂为部分厚度撕裂。无肌腱撕裂的受试者年龄显著更低（P 研究结论：脊髓损伤手动轮椅使用者中，轻度及中度肩部肌腱病与部分厚度肌腱撕裂的患病率极高。此外，本研究结果提示，针对该人群的肩部病变监测策略不应过度依赖患者自述的疼痛情况，而应更多关注轮椅使用年限与年龄因素。