OBJECTIVE: To compare the diagnostic accuracy of supraspinatus muscle outlet X-ray film, oblique sagittal multislice helical CT (MSCT), and oblique sagittal MRI in the diagnosis of subacromial impingement syndrome (SIS). METHODS: A retrospective analysis was conducted on the imaging data of 106 patients diagnosed with SIS between January 2023 and December 2024. The cohort consisted of 32 males and 74 females, with ages ranging from 43 to 70 years (mean, 60.19 years). All patients underwent supraspinatus muscle outlet X-ray film, MSCT, and MRI scans, with MSCT further subjected to three-dimensional reconstruction. Two experienced radiologists independently evaluated the acromion morphology in each imaging modality using the Bigliani classification system. Inter-observer reliability was assessed via Kappa statistics. The CT three-dimensional reconstructions were used as the "gold standard". The overall consistency, Kappa values, sensitivity, and specificity of the three imaging modalities were calculated. Receiver operating characteristic (ROC) curves were plotted, and the area under the curve (AUC) was computed. RESULTS: The inter-observer reliability for supraspinatus muscle outlet X-ray film, oblique sagittal MSCT, and oblique sagittal MRI was moderate, with Kappa values of 0.62, 0.63, and 0.55, respectively. When compared to the CT three-dimensional reconstructions as the "gold standard", the overall consistency was 88.7% (94/106), 62.3% (66/106), and 58.5% (62/106), respectively. The supraspinatus muscle outlet X-ray film showed excellent consistency (Kappa=0.77), whereas the consistency of MSCT and MRI was lower (Kappa=0.34 and 0.29, respectively). In terms of diagnostic sensitivity and specificity, the supraspinatus muscle outlet X-ray film outperformed oblique sagittal MSCT and oblique sagittal MRI in distinguishing various acromion types. ROC analysis demonstrated that the AUC for the supraspinatus muscle outlet X-ray film was consistently higher than for oblique sagittal MSCT and oblique sagittal MRI, with the highest diagnostic performance observed for type Ⅲ hooked acromion (AUC=0.939). CONCLUSION Supraspinatus muscle outlet X-ray film provides the highest diagnostic accuracy for acromion classification in SIS patients, particularly in identifying type Ⅲ hooked acromion, which is strongly associated with SIS. Given its superior sensitivity and consistency, it should be considered the primary screening tool. MSCT and MRI serve as valuable supplementary modalities for complex cases and preoperative evaluation.
Humans ; Middle Aged ; Male ; Female ; Shoulder Impingement Syndrome/diagnostic imaging* ; Magnetic Resonance Imaging/methods* ; Retrospective Studies ; Aged ; Adult ; Imaging, Three-Dimensional ; Sensitivity and Specificity ; Tomography, Spiral Computed/methods* ; Multidetector Computed Tomography/methods* ; Reproducibility of Results

Objective To investigate the effect of acupuncture point injection and rehabilitation on the functional recovery of upper limbs and daily living ability of shoulder-hard syndrom (SHS) after cerebral hemorrhage. Methods A total of 96 patients SHS after cerebral hemorrhage were divided into the observation group (n=56) and the control group (n=40). Both groups recieved the routine treatment for cerebral hemorrhage and rehabilitation technique training. Besides, the control group was treated with intermediate frequency physiotherapy, and the observation group was treated with electroacupuncture and acupoint injection of Salvia miltiorrhiza and ligustrazine. After 1 months of treatment, the the upper limb movement function, daily living ability (ADL), shoulder joint pain, joint activity degree, and the degree of joint swelling were evaluated and compared. Results After treatment, the FMA (60.1 ± 6.4 vs. 41.8 ± 18.7, t=6.799), MBI (65.2 ± 3.5 vs. 50.6 ± 2.1, t=23.512) scores of the observation group were significantly higher than those of the control group. The VAS (2.7 ± 1.4 vs. 4.9 ± 1.3, t=7.817), edema volume (2.1 ± 2.1 cm3 vs. 2.1 ± 2.1 cm3, t=7.316) of the observation group were significantly lower than those of the control group ( P＜0.01). The anterior flexion (163.1 ± 6.7°vs. 56 ± 10.9°, t=59.516), extension (39.6 ± 5.8°vs. 23.2 ± 6.7°, t=12.799), abduction (168.1 ± 9.6°vs. 52.1 ± 8.9°, t=60.148), adduction (52.1 ± 3.6°vs. 29.8 ± 4.3°, t=27.580), external rotation (49.8 ± 7.6°vs. 23.2 ± 5.2°, t=19.151), internal rotation (107.0 ± 8.5°vs. 60.2 ± 6.1°, t=29.758) of the observation group were significantly higher than those of the control group (P＜0.01). The total effective rate of the observation group was 91.1% (52/56) and the control group was 70% (28/40), and the difference between the 2 groups was statistically significant (χ2=7.209, P＜0.01). Conclusions Acupuncture combined with acupoint injection and rehabilitation technology can relieve pain, eliminate edema and improve motor function and daily living ability of SHS patients after intracerebral hemorrhage.