Predictive value of subacromial motion metrics for the effectiveness of ultrasound-guided dual-target injection: a longitudinal follow-up cohort trial.

IF 4.1 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Insights into Imaging Pub Date : 2025-07-01 DOI:10.1186/s13244-025-01989-5

Wei-Ting Wu, Che-Yu Lin, Yi-Chung Shu, Lan-Rong Chen, Levent Özçakar, Ke-Vin Chang

{"title":"Predictive value of subacromial motion metrics for the effectiveness of ultrasound-guided dual-target injection: a longitudinal follow-up cohort trial.","authors":"Wei-Ting Wu, Che-Yu Lin, Yi-Chung Shu, Lan-Rong Chen, Levent Özçakar, Ke-Vin Chang","doi":"10.1186/s13244-025-01989-5","DOIUrl":null,"url":null,"abstract":"Objective: Subacromial impingement syndrome (SIS) frequently causes shoulder pain. This study aimed to (1) assess the predictive utility of quantitative dynamic subacromial ultrasound for ultrasound-guided dual-target injections and (2) compare the long-term efficacy of dual-target injections with standard subdeltoid-subacromial injections in SIS patients.Methods: Patients with SIS received 40 mg of triamcinolone acetonide via ultrasound-guided dual-target injections (subdeltoid-subacromial bursa and long head of the biceps brachii tendon). Clinical assessments and static/dynamic ultrasound were performed at baseline and 4 weeks post-procedure. Minimal vertical acromiohumeral distance (mVAHD) was measured by tracing the humeral greater tuberosity against the acromion. A historical cohort receiving standard subdeltoid-subacromial corticosteroid injections was used for comparison.Results: Of 90 patients receiving dual-target injections, 70 (77.7%) achieved early treatment success. An enlarged minimal mVAHD was associated with success, except during the abduction phase in the full-can posture. Among these 70 patients, 25 (35.7%) had shoulder pain recurrence requiring repeat injections, linked to a decreased mVAHD across all phases and postures. Compared to 90 patients in a historical cohort receiving standard subdeltoid-subacromial injections, the dual-target group had a significantly longer mean time to pain recurrence (309.1 ± 130.1 days vs. 267.5 ± 184.2 days, p = 0.03).Conclusion: Dynamic ultrasound metrics, including mVAHD, predict early success and pain recurrence following dual-target injections in SIS. Dual-target injections offer a longer duration of effectiveness compared to standard subdeltoid-subacromial injections. Future research should explore the predictive value of mVAHD with deep learning algorithms and evaluate the approach in adhesive capsulitis.Trial registration: ClinicalTrials.gov (NCT04219527). Registered on 27 December 2019, https://clinicaltrials.gov/study/NCT04219527 .Critical relevance statement: Dynamic ultrasound metrics predict early success and pain recurrence following dual-target injections in SIS, offering a longer duration of effectiveness compared to standard subdeltoid-subacromial injections.Key points: Dynamic ultrasound metrics predict injection success and pain recurrence in impingement. Dual-target injections offer a longer duration of effectiveness than standard injections. Future research should assess deep learning's predictive value in adhesive capsulitis.","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"16 1","pages":"145"},"PeriodicalIF":4.1000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Insights into Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13244-025-01989-5","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: Subacromial impingement syndrome (SIS) frequently causes shoulder pain. This study aimed to (1) assess the predictive utility of quantitative dynamic subacromial ultrasound for ultrasound-guided dual-target injections and (2) compare the long-term efficacy of dual-target injections with standard subdeltoid-subacromial injections in SIS patients.

Methods: Patients with SIS received 40 mg of triamcinolone acetonide via ultrasound-guided dual-target injections (subdeltoid-subacromial bursa and long head of the biceps brachii tendon). Clinical assessments and static/dynamic ultrasound were performed at baseline and 4 weeks post-procedure. Minimal vertical acromiohumeral distance (mVAHD) was measured by tracing the humeral greater tuberosity against the acromion. A historical cohort receiving standard subdeltoid-subacromial corticosteroid injections was used for comparison.

Results: Of 90 patients receiving dual-target injections, 70 (77.7%) achieved early treatment success. An enlarged minimal mVAHD was associated with success, except during the abduction phase in the full-can posture. Among these 70 patients, 25 (35.7%) had shoulder pain recurrence requiring repeat injections, linked to a decreased mVAHD across all phases and postures. Compared to 90 patients in a historical cohort receiving standard subdeltoid-subacromial injections, the dual-target group had a significantly longer mean time to pain recurrence (309.1 ± 130.1 days vs. 267.5 ± 184.2 days, p = 0.03).

Conclusion: Dynamic ultrasound metrics, including mVAHD, predict early success and pain recurrence following dual-target injections in SIS. Dual-target injections offer a longer duration of effectiveness compared to standard subdeltoid-subacromial injections. Future research should explore the predictive value of mVAHD with deep learning algorithms and evaluate the approach in adhesive capsulitis.

Trial registration: ClinicalTrials.gov (NCT04219527). Registered on 27 December 2019, https://clinicaltrials.gov/study/NCT04219527 .

Critical relevance statement: Dynamic ultrasound metrics predict early success and pain recurrence following dual-target injections in SIS, offering a longer duration of effectiveness compared to standard subdeltoid-subacromial injections.

Key points: Dynamic ultrasound metrics predict injection success and pain recurrence in impingement. Dual-target injections offer a longer duration of effectiveness than standard injections. Future research should assess deep learning's predictive value in adhesive capsulitis.

查看原文本刊更多论文

肩峰下运动指标对超声引导双靶点注射有效性的预测价值：一项纵向随访队列试验。

目的：肩峰下撞击综合征（SIS）常引起肩痛。本研究旨在(1)评估定量动态肩峰下超声对超声引导双靶点注射的预测效用；(2)比较双靶点注射与标准三角肌下-肩峰下注射在SIS患者中的长期疗效。方法：超声引导下双靶点注射曲安奈德40 mg（三角下-肩峰下滑囊和肱二头肌肌腱长头）。在基线和术后4周进行临床评估和静态/动态超声检查。最小肩肱骨垂直距离（mVAHD）通过追踪肱骨大结节对肩峰测量。一个接受标准三角肌下-肩峰下皮质类固醇注射的历史队列被用于比较。结果：90例双靶注射患者中，早期治疗成功70例（77.7%）。增大的最小mVAHD与成功相关，除了在全髋位的外展阶段。在这70例患者中，25例（35.7%）有肩部疼痛复发，需要重复注射，这与所有阶段和姿势的mVAHD下降有关。与接受标准三角肌下-肩峰下注射的90例患者相比，双靶点组疼痛复发的平均时间明显更长（309.1±130.1天vs 267.5±184.2天，p = 0.03）。结论：动态超声指标，包括mVAHD，可预测SIS双靶点注射后的早期成功和疼痛复发。与标准的三角肌下-肩峰下注射相比，双靶点注射提供了更长的有效时间。未来的研究应探索深度学习算法对mVAHD的预测价值，并评估该方法在粘连性囊炎中的应用价值。试验注册：ClinicalTrials.gov （NCT04219527）。关键相关性声明：动态超声指标预测SIS双靶点注射后的早期成功和疼痛复发，与标准三角肌下-肩峰下注射相比，提供更长的有效时间。重点：动态超声指标预测撞击后注射成功和疼痛复发。双靶注射比标准注射提供更长的有效时间。未来的研究应评估深度学习在粘连性囊炎中的预测价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Insights into Imaging Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

7.30

自引率

4.30%

发文量

182

审稿时长

13 weeks

期刊介绍： Insights into Imaging (I³) is a peer-reviewed open access journal published under the brand SpringerOpen. All content published in the journal is freely available online to anyone, anywhere! I³ continuously updates scientific knowledge and progress in best-practice standards in radiology through the publication of original articles and state-of-the-art reviews and opinions, along with recommendations and statements from the leading radiological societies in Europe. Founded by the European Society of Radiology (ESR), I³ creates a platform for educational material, guidelines and recommendations, and a forum for topics of controversy. A balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes I³ an indispensable source for current information in this field. I³ is owned by the ESR, however authors retain copyright to their article according to the Creative Commons Attribution License (see Copyright and License Agreement). All articles can be read, redistributed and reused for free, as long as the author of the original work is cited properly. The open access fees (article-processing charges) for this journal are kindly sponsored by ESR for all Members. The journal went open access in 2012, which means that all articles published since then are freely available online.