Abstract
Background
High signal intensity (HSI) on T2-weighted or fat-suppressed magnetic resonance imaging
(MRI) around the shoulder is often observed in patients who have a rotator cuff tear,
and is generally recognized as an indicator of shoulder pain, especially pain at night.
We hypothesized these HSI volumes are reduced after improvement of symptoms. We sought
to compare HSI before and after conservative treatment, and to determine if HSI is
associated with the patient's pain status over time.
Methods
We enrolled 55 patients (average age 65 years) into the study. All the patients complained
of pain at night (University of California, Los Angeles (UCLA) pain score ≤2, Japanese
Orthopedic Association (JOA) pain score ≤10) at their initial visits and underwent
conservative treatment. MRI was obtained at their initial visit and after improvement
of pain when their initial UCLA pain score was ≥6 points or JOA pain score was ≥20
points. The mean time between the MRI examinations was 11.8 months (SD 7.7) (range
2.5–39). HSI was assessed at the location of the subacromial–subdeltoid bursa, glenohumeral
joint, subcoracoid bursa, and sheath of the long head of the biceps tendon, and graded.
Factors correlating with the improvement of MRI findings were evaluated retrospectively.
Results
HSI had improved in 30 shoulders in all or some of the locations (I-group). There
was no change in 25 shoulders for any location or aggravation in one or more locations
(N-group). Multivariate logistic regression analysis found that the time from pain
improvement until the second MRI was the only independent factor related to the improvement
in HSI (p = .045).
Conclusion
Improvement of shoulder symptoms is not directly associated with MRI findings. Improvement
in HSI followed symptom improvement after a delay; the changes varied for each shoulder
location.
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Article info
Publication history
Published online: January 08, 2022
Accepted:
December 19,
2021
Received in revised form:
December 3,
2021
Received:
June 8,
2021
Identification
Copyright
© 2021 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.
