Clinical and radiographic evaluation of the shoulder of spinal cord injured patients undergoing rehabilitation program.

STUDY

DESIGN

Clinical and radiographic evaluation of the shoulders of tetraplegic and paraplegic patients who attend rehabilitation program.

OBJECTIVES

The objective of this study is to establish the usefulness of radiography as a trial exam for shoulder pain in spinal cord injured patients.

SETTING

Hospital das Clinicas-UNICAMP. Campinas, Sao Paulo, Brazil.

METHODS

Thirty-two shoulders of 16 patients were evaluated by clinical exam and radiography. Patients were divided into two groups: paraplegic and tetraplegic. A control group of 16 normal volunteer subjects was selected.

RESULTS

Shoulder pain was reported in 88.89% of tetraplegic and 42.85% of paraplegic. The time of injury ranged from 1.5-22 years (mean 7.88 years); patients had a mean age of 34.68 years (range, 21-57 years). The acromioclavicular joint (ACJ) space ranged from 0.03-0.7 cm on the right side and 0.15-0.7 cm on the left side, with a mean of 0.37 and 0.41 cm, respectively. No correlation was found between shoulder pain and gender, age or time since injury. There was a trend to correlation between shoulder pain and type of injury with tetraplegic having a tendency to pain symptoms. On average, tetraplegic had smaller ACJ.

CONCLUSIONS

The small number of patients in this study did not allow us to confirm the hypothesis that X-ray finding may indicate risk for shoulder pain in spinal cord injury patients. A work with a greater number of subjects could demonstrate association between shoulder pain and the reduced acromioclavicular distance, making plain radiography a trial exam for spinal cord-injured patients.