• 한국방사선학회논문지
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• 제16권7호
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• pp.961-968
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• 2022

회전근개 파열은 성인 어깨 통증의 주요 원인이다. 사회활동의 증가로 인해 어깨 통증을 호소하는 환자가 증가하고 있으며, 어깨질환에 대한 관심도 높아지고 있다. 초음파 장비의 발달로 진단의 정확도가 높아지면서 근골격계 질환 중에서 회전근개 파열 진단에 주로 이용되면서 초음파검사는 회전근개 파열에서 MRI 검사를 보완할 수 있는 방법으로 인정받고 있다. 따라서 본 연구에서는 어깨 회전근개 파열의 진단에 있어 초음파와 MRI 검사의 진단적 유용성을 알아보고자 하였다. 초음파검사와 MRI검사를 완료한 후 관절내시경검사로 최종 회전근개의 손상을 진단받은 환자 262명을 대상으로 후향적 분석을 하였다. 회전근개중 파열의 빈도가 가장 높은 극상건과 견갑하건 두 힘줄의 초음파검사와 MRI검사의 결과에 대한 민감도, 특이도, 양성예측도, 음성예측도, 정확도를 분석하였다. 또한 회전근개파열의 정도를 5단계로 점수화하여 비교하였다. 초음파 검사는 전층파열과 부분파열 모두 MRI 검사 결과와 유사하였고 통계적으로 유의한 차이는 없었다. 부분파열 검사 결과는 MRI 검사보다 양성예측도와 정확도가 높았다. 결론적으로 초음파는 회전근개 질환을 검사하기 위한 선별검사로 충분히 활용될 수 있으며, 환자의 체질과 상황에 따라 선택하여 임상적으로 활용될 것으로 생각된다.

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2009년도 제17차 학술대회
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• pp.90-90
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• 2009

• Journal of Acupuncture Research
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• 제31권4호
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• pp.109-119
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• 2014

Objectives : The aim of this study is to observe clinical characteristics and treatment outcomes of inpatients admitted to a Korean medicine hospital for shoulder pain based on magnetic resonance imaging(MRI) findings. Methods : 28 patients with MRI data were included. Data on MRI findings, duration of pain, and treatment effects were collected. To measure treatment outcomes, verbal numerical rating scale(VNRS), range of motion(ROM), and a clinical condition grading system were used. Results : 1. The patient population was 75.0 % female and 39.3 %(n=11) belonged to the 51~60-year-old age group. In the under 40 population, 1 or less MRI findings were found. 2. As for the type of disorder, 82.1 % of the patients were diagnosed with 'Supraspinatus lesion', 39.3 % with 'subacromial-subdeltoid(SA-SA) bursitis', and 28.6 % with 'Adhesive capsulitis' 3. Numerous correlations could be made between duration of pain and MRI findings. 'rotator cuff full thickness tear' was more prevalent in acute shoulder pain patients, and 'Adhesive capsulitis' in chronic patients. 4. VNRS and ROM at the time of discharge had significantly improved as compared to VNRS and ROM at the time of admission. 5. As for correlation between MRI findings and clinical condition grade, patients diagnosed with 'rotator cuff partial tear' reported to be in 'good' condition or better whereas those with 'rotator cuff full thickness tear' reported to be in 'fair' condition or worse. Conclusions : Patients admitted to a Korean Medicine hospital for shoulder pain had varying degrees of severity as shown on MRI. Almost all lesions responded well to Korean medicine treatment.

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2002년도 아시아견관절학술대회
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• pp.23-38
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• 2002

[ ${\cdot}$ ] Instability in the overhead athlete complicated ${\cdot}$ Consider other pathologies: Internal Impingement SLAP ${\cdot}$ Diagnose by Hx, Px, MRI, EUA, and arthroscopy

• Clinics in Shoulder and Elbow
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• 제24권2호
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• pp.98-105
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• 2021

Background: Our aim is to determine the interobserver reliability for surgeons to detect Hill-Sachs lesions on magnetic resonance imaging (MRI), the certainty of judgement, and the effects of surgeon characteristics on agreement. Methods: Twenty-nine patients with Hill-Sachs lesions or other lesions with a similar appearance on MRIs were presented to 20 surgeons without any patient characteristics. The surgeons answered questions on the presence of Hill-Sachs lesions and the certainty of diagnosis. Interobserver agreement was assessed using the Fleiss' kappa (κ) and percentage of agreement. Agreement between surgeons was compared using a technique similar to the pairwise t-test for means, based on large-sample linear approximation of Fleiss' kappa, with Bonferroni correction. Results: The agreement between surgeons in detecting Hill-Sachs lesions on MRI was fair (69% agreement; κ, 0.304; p<0.001). In 84% of the cases, surgeons were certain or highly certain about the presence of a Hill-Sachs lesion. Conclusions: Although surgeons reported high levels of certainty for their ability to detect Hill-Sachs lesions, there was only a fair amount of agreement between surgeons in detecting Hill-Sachs lesions on MRI. This indicates that clear criteria for defining Hill-Sachs lesions are lacking, which hampers accurate diagnosis and can compromise treatment.

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2005년도 제13차 춘계학술대회
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• pp.107-111
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• 2005

29세의 남자 환자는 내원 2년전부터 견관절 심부의 간헐적인 동통과 근력약화 증상을 보이다가 내원 2개월전부터 지속적이고 심한 견관절 통증 및 야간통을 주소로 내원하였다. 이학적 검사, MRI검사 및 근전도 검사로 결절종에 의한 상견갑 신경 포착증후군으로 확진되었으며 관절경하에서 후상방 관절낭부위를 탐침하여 관절낭 절개술을 시행하여 결절종 제거수술을 시행하였다. 이때 관절경 소견상 후상방 관절와순은 정상소견을 보였으며 SLAP병변은 관찰되지 않았다. 그후 환자는 큰 불편함은 없었으나 술후 2년 경과후에 외전 및 외회전시 나타나는 통증 및 경도의 견관절 후방부 통증을 주소로 내원하여 MRI검사를 시행하였다. 이때 결정종의 재발은 관찰되지 않았으나 SLAP 병변이 의심되어, 관절경검사를 시행한후 SLAP 병변 봉합술을 시행하였다. 현재 환자는 술후 6개월째로 만족스러운 상태로 직업에 복귀한 상태이다.

• 대한영상의학회지
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• 제81권1호
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• pp.2-20
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• 2020

MRI 영상은 관절 내 질환의 평가에 중요한 검사기법이며, 관절 MRI 영상의 해석을 위해선 견고한 해부학적 지식이 바탕이 되어야 한다. 관절의 해부학 분야에서는, 새로운 구조물이 발견되기도 하며, 과거에 보고되었으나 기능을 알지 못하던 구조물이 새롭게 주목을 받기도 한다. 본 종설에서는 최근 십여 년간 활발하게 연구되어온 견관절 회전근개 케이블(rotator cable) 및 상관절막(superior capsule), 슬관절의 후외측(posterolateral corner) 및 전외측 인대 복합(anterolateral ligament complex), 발목관절의 원위부 경비골 인대결합(distal tibiofibular syndesmosis) 등의 최근 연구 결과를 소개하고, 이를 MRI 영상을 통해 확인해 보았다.

• 대한관절경학회지
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• 제14권3호
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• pp.188-191
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• 2010

상완이두장건의 결손은 매우 드문 이상이다. 본원에 내원한 19세 남환은 우측 견관절 아탈구 증상을 주소로 내원하였다. MRI 상 상완골의 얕은 결절사이고랑이 관찰되었으며 상완이두장건의 결손이 관찰되었다. 견관절 내시경술을 시행하였으며 관절와순 파열과 함께 상완이두장건의 결손이 관찰되었다. 5개월 뒤 좌측 견관절에도 우측 견관절과 같은 증상이 발생하였고 MRI 및 견관절 내시경 소견 상 상완이두장건의 결손 소견 및 관절와순 파열 소견이 관찰되었다. 양측 견관절 모두 내시경적 관절와순 봉합술을 시행하였으며 수술 후 위팔 외전 보조기를 이용하여 고정하였다. 상완이두장건의 결손이 견관절의 불안정성을 유발할 수 있을 것이라고 생각한다.

• Clinics in Shoulder and Elbow
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• 제25권3호
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• pp.182-187
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• 2022

Background: This study was designed to evaluate and compare the diagnostic value of magnetic resonance imaging (MRI) and indirect magnetic resonance arthrography (I-MRA) imaging with those of arthroscopy and each other. Methods: This descriptive-analytical study was conducted in 2020. All patients who tested positive for labrum lesions during that year were included in the study. The patients underwent conservative treatment for 6 weeks. In the event of no response to conservative treatment, MRI and I-MRA imaging were conducted, and the patients underwent arthroscopy to determine their ultimate diagnosis and treatment plan. Imaging results were assessed at a 1-week interval by an experienced musculoskeletal radiologist. Image interpretation results and arthroscopy were recorded in the data collection form. Results: Overall, 35 patients comprised the study. Based on the kappa coefficient, the results indicate that the results of both imaging methods are in agreement with the arthroscopic findings, but the I-MRA consensus rate is higher than that of MRI (0.612±0.157 and 0.749±0.101 vs. 0.449±0.160 and 0.603±0.113). The sensitivity, specificity, negative predictive value, positive predictive value, and accuracy of MRI in detecting labrum tears were 77.77%, 75.00%, 91.30%, 50.00%, and 77.14%, respectively, and those of I-MRA were 88.88%, 75.00%, 92.30%, 66.66%, and 85.71%. Conclusions: Here, I-MRA showed higher diagnostic value than MRI for labral tears. Therefore, it is recommended that I-MRA be used instead of MRI if there is an indication for potential labrum lesions.

• Clinics in Shoulder and Elbow
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• 제21권2호
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• pp.82-86
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• 2018

Background: Although a common shoulder disease, there are no accepted classification criteria for frozen shoulder (FS). This study therefore aimed to evaluate the accuracy of the conventionally used FS classification system. Methods: Primary FS patients (n=168) who visited our clinic from January 2010 to July 2015 were included in the study. After confirming restrictions of the glenohumeral joint motion and absence of history of systemic disease, trauma, shoulder surgery, shoulder muscle weakness, or specific x-ray abnormalities, the Zuckerman and Rokito's classification was employed for diagnosing primary FS. Following clinical diagnosis, each patient underwent a shoulder magnetic resonance imaging (MRI) and blood tests (lipid profile, glucose, hemoglobin A1c, and thyroid function). Based on the results of the blood tests and MRIs, the patients were reclassified, using the criteria proposed by Zuckerman and Rokito. Results: New diagnoses were ascertained including blood test results (16 patients with diabetes, 43 with thyroid abnormalities, and 149 with dyslipidemia), and MRI revealed intra-articular lesions in 81 patients (48.2%). After re-categorization based on the above findings, only 5 patients (3.0%) were classified having primary FS. The remaining 163 patients (97.0%) had either undiagnosed systemic or intrinsic abnormalities (89 patients), whereas 74 patients had both. Conclusions: These findings demonstrate that most patients clinically diagnosed with primary FS had undiagnosed systemic abnormalities and/or intra-articular pathologies. Therefore, a modification of the Zuckerman and Rokito's classification system for FS may be required to include the frequent combinations, rather than having a separate representation of systemic abnormalities and intrinsic causes.