Painful and painless shoulder Magnetic Resonance Imaging comparisons in hemodialysis patients and correlation with clinical findings

Article type: Research Article

Authors: Turk, Ayla Cagliyan^{a; *} | Fidan, Nurdan^b | Ozcan, Oguzhan^c | Ozdemir, Ferda^d | Tomak, Leman^e | Ozkurt, Sultan^f | Sahin, Fusun^g

Affiliations: [a] Department of Physical Medicine and Rehabilitation, Hitit University Training and Research Hospital, Corum, Turkey | [b] Department of Radiology, Hitit University Training and Research Hospital, Corum, Turkey | [c] Department of Biochemistry, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey | [d] Department of Physical Medicine and Rehabilitation, Kolan International Hospital, Sisli, Istanbul, Turkey | [e] Department of Biostatistics, Faculty of Medicine, Ondokuzmayıs University, Samsun, Turkey | [f] Department of Nephrology, Hitit University Training and Research Hospital, Corum, Turkey | [g] Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Pamukkale University, Denizli, Turkey

Correspondence: [*] Corresponding author: Ayla Cagliyan Turk, Department of Physical Medicine and Rehabilitation, Hitit University, Training and Research Hospital, Corum 19200, Turkey. Tel.: +90 364 223 03 00; Fax: +90 364 223 03 23; E-mail:drayla1976@hotmail.com

Abstract: BACKGROUND: Shoulder pain is frequently observed in haemodialysis patients. OBJECTIVE: To compare haemodialysis patients with or without shoulder pain in terms of shoulder motion ranges, β2 microglobulin levels and magnetic resonance imaging findings. METHODS: Forty-three patients undergoing dialysis were enrolled, of which 23 patients had explicit shoulder pain at night, which appeared during dialysis. Range of joint motion was evaluated. β 2 microglobulin value was recorded. MRI was used to evaluate rotator cuff tendons for thickness, homogeneity, integrity and presence of effusion. RESULTS: Ranges of motion were significantly lower in the painful shoulder group. Supraspinatus tendon thickness and the number of areas with effusion were higher in the painful group. There was a positive correlation between the β 2 microglobulin level and supraspinatus (r:0.352 p< 0.05) and subscapular (r:0.454 p< 0.05) tendon thicknesses. While effusion areas and pain (r:0.351 p< 0.05) showed positive correlation, there was a negative correlation between pain and shoulder motion ranges. CONCLUSIONS: Shoulder pain in dialysis patients can be related with tendon thickness and effusion. While the β 2 microglobulin level affects tendon thickness, it has no relation to pain and movement constraint.

Keywords: Amyloidosis, β 2 microglobulin, haemodialysis, Magnetic Resonance Imaging, shoulder pain

DOI: 10.3233/BMR-160715

Journal: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 1, pp. 63-69, 2017