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Ibounig T, Buchbinder R, Sillanpää N, Rämö L, Toivonen P, Raatikainen S, Koskinen S, Härkänen T, Rissanen H, Czuba T, Paavola M, Jarvinen T, Taimela S. Concordance of shoulder symptoms and imaging findings: a protocol for the Finnish Imaging of Shoulder (FIMAGE) study. BMJ Open 2023; 13:e074457. [PMID: 38154899 PMCID: PMC10759117 DOI: 10.1136/bmjopen-2023-074457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 11/27/2023] [Indexed: 12/30/2023] Open
Abstract
INTRODUCTION Shoulder pain is a substantial medical and socioeconomic problem in most societies, affecting the ability to work or carry out leisure time activities as well as subsequently influencing physical and psychological well-being. According to a nationwide survey in Finland, 27% of the population reported shoulder pain within the last 30 days. In clinical practice, imaging findings of structural abnormalities are typically thought to explain symptoms, even though such findings are also prevalent in asymptomatic individuals, particularly with increasing age. Overall, there is a paucity of high-quality evidence on the prevalence, clinical relevance and prognosis of 'abnormal' imaging findings of the shoulder.The aim of the Finnish Imaging of Shoulder (FIMAGE) study is fourfold: to assess (1) the prevalence of shoulder symptoms and the most common anatomical variants and imaging abnormalities of the shoulder; (2) the concordance between shoulder symptoms, function and imaging abnormalities; (3) the most important determinants of symptoms, function and imaging abnormalities; and (4) the course of shoulder complaints over 5 years. METHODS The FIMAGE target population of 600 participants, aged 40-75 years, will be randomly selected from a nationally representative general population sample of 9922 individuals originally recruited for the Finnish Health 2000 Survey. On giving informed consent, the participants will be invited to a clinical visit that includes assessment of general health, shoulder symptoms, bilateral shoulder examination and imaging of both shoulders with plain radiography and MRI. ETHICS AND DISSEMINATION The study has been approved by the Institutional Review Board of the Helsinki and Uusimaa Hospital District. The findings will be published according to the Strengthening the Reporting of Observational Studies in Epidemiology criteria. TRIAL REGISTRATION NUMBER NCT05641415.
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Affiliation(s)
- Thomas Ibounig
- Department of Orthopaedics and Traumatology, Helsinki University Central Hospital, Helsinki, Finland
- Finnish Centre for Evidence-Based Orthopaedics, University of Helsinki, Helsinki, Finland
| | - Rachelle Buchbinder
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Niko Sillanpää
- Finnish Centre for Evidence-Based Orthopaedics, University of Helsinki, Helsinki, Finland
- Tampere University Hospital, Tampere, Finland
| | - Lasse Rämö
- Department of Orthopaedics and Traumatology, Helsinki University Central Hospital, Helsinki, Finland
- Finnish Centre for Evidence-Based Orthopaedics, University of Helsinki, Helsinki, Finland
| | - Pirjo Toivonen
- Finnish Centre for Evidence-Based Orthopaedics, University of Helsinki, Helsinki, Finland
| | - Saara Raatikainen
- Department of Orthopaedics and Traumatology, Helsinki University Central Hospital, Helsinki, Finland
- Finnish Centre for Evidence-Based Orthopaedics, University of Helsinki, Helsinki, Finland
| | - Seppo Koskinen
- Population Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Tommi Härkänen
- Population Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Harri Rissanen
- Population Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Tomasz Czuba
- Department of Molecular and Clinical Medicine, University of Gothenburg, Goteborg, Sweden
| | - Mika Paavola
- Department of Orthopaedics and Traumatology, Helsinki University Central Hospital, Helsinki, Finland
| | - Teppo Jarvinen
- Department of Orthopaedics and Traumatology, Helsinki University Central Hospital, Helsinki, Finland
- Finnish Centre for Evidence-Based Orthopaedics, University of Helsinki, Helsinki, Finland
| | - Simo Taimela
- Department of Orthopaedics and Traumatology, Helsinki University Central Hospital, Helsinki, Finland
- Finnish Centre for Evidence-Based Orthopaedics, University of Helsinki, Helsinki, Finland
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Karjalanen T, Raatikainen S, Jaatinen K, Lusa V. Update on Efficacy of Conservative Treatments for Carpal Tunnel Syndrome. J Clin Med 2022; 11:jcm11040950. [PMID: 35207222 PMCID: PMC8877380 DOI: 10.3390/jcm11040950] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 01/31/2022] [Accepted: 02/09/2022] [Indexed: 12/13/2022] Open
Abstract
Carpal tunnel syndrome (CTS) is the most common upper extremity compression neuropathy. Non-operative interventions are usually the first-line treatments, and surgery is reserved for those that do not achieve a satisfactory symptom state by non-operative means. This narrative review summarizes the current evidence regarding the efficacy of orthoses, corticosteroid injections, platelet-rich plasma injections, Kinesio taping, neurodynamic techniques, gabapentin, therapeutic ultrasound, and extracorporeal shockwave therapy in people with CTS. While many trials suggest small short-term benefits, rigorous evidence of long-term patient-important benefits is limited. To improve the utility of healthcare resources, research in this area should focus on establishing efficacy of each treatment instead of comparing various treatments with uncertain benefits.
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Affiliation(s)
- Teemu Karjalanen
- Department of Hand and Micosurgery, Tampere University Hospital, 33521 Tampere, Finland
- Monash Department of Clinical Epidemiology, Cabrini Institute, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Malvern, Melbourne 3144, Australia
- Correspondence:
| | - Saara Raatikainen
- Musculoskeletal and Plastic Surgery Department, University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland;
| | - Kati Jaatinen
- Central Finland Healthcare District, 40620 Jyväskylä, Finland; (K.J.); (V.L.)
| | - Vieda Lusa
- Central Finland Healthcare District, 40620 Jyväskylä, Finland; (K.J.); (V.L.)
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