Report of Two Cases of Shoulder Pain Diagnosed through MRI as Partial Tear of Supraspinatus Tendon Treated by Oriental Medical Treatment

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서 론

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2) .

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(repetitive microtrauma) .

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정다운¹, 송수철¹, 여경찬¹, 김기역², 이현주³, 문성일¹

1국립의료원 한방진료부 침구과, ²부천자생한방병원 침구과, ³제인한방병원 한방내과

Case Report

Report of Two Cases of Shoulder Pain Diagnosed through MRI as Partial Tear of Supraspinatus Tendon Treated by Oriental Medical Treatment

Da-Un Jeong¹, Soo-Cheol Song¹, Kyeong-Chan Yeo¹, Ki-Yuk Kim², Hyun-Ju Lee³, Sung-Il Moon¹

1Department of Acupuncture & Moxibustion, National Medical Center, Seoul, Korea

2Department of Acupuncture & Moxibustion, Bucheon JaSeng Hospital of Oriental Medicine, Bucheon, Korea

3Department of Oriental Internal Medicine, Jein Oriental Medical Hospital, Seoul, Korea

Objectives: The purpose of this study is to report the improvement after oriental medical treatment of partial tear of supraspinatus tendon.

Method: We treated 2 patients having shoulder pain due to partial tear of supraspinatus tendon with Oriental medical treatment, including Sa-am acupuncture DaeJang-Jeonggyeok, A-shi point ( )and herbal medicine. We checked visual analog scale (VAS) score and range of movement (ROM).

Results: We treated shoulder pain. Thereafter ROM improved and VAS score dropped to the level of 2 to 4 points from 10 points at onset.

Conclusion: This report shows Oriental medical treatment has effectiveness on partial tear of supraspinatus tendon.

Follow-up study is needed.

Key Words : Supraspinatus, Partial tear, Shoulder pain, Oriental medical treatment.

접수：2008년 9월 19일 수정：2008년 12월 29일 채택：2009년 1월 5일

교신저자：문성일(Sung-Il Moon)

서울 중구 을지로 6가 18-79 국립의료원 한방진료부 침구과

Tel：+82-2-2260-7449, Fax：+82-2-2260-7464, E-mail：[email protected]

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MRI Partial tear of supraspinatus tendon

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Passive

Flexion 180°

Active

Flexion 70°

Extension 45° Extension 0°

Abduction 180° Abduction 20°

Adduction 30° Adduction 10°

External rotation 75° External rotation 20°

Internal rotation 90° Internal rotation 30°

Table 1.

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AST 16U/L, ALT 15U/L Lab Within Normal limit

(3) Shoulder MRI (Fig. 1) (Fig. 2)

Anterior acromion downward slop bony

spur .

Supraspinatus tendon irregular thinning

signal partial .

, joint space other ligaments .

IMP)Partial tear of supraspinatus tendon (4)

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Drug name Drug Category

Dose

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diomagnate susp. antiacids tid bid none

Eperisone HCl 50mg muscle relaxants tid bid none

Tramadol HCl /Acetaminophen analgesics tid bid none

Streptokinase/Streptodornase anti-inflammatory enzymes tid none none

Sofalcone 100mg antiulcerants tid bid none

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HOD Shoulder ROM Shoulder Pain & Upper Limb

Numbness Sleep Others

07.8.16 1

Adbuction(Abd) 20°, Flexion(Flex) 70°

Drop arm test(+)

C6-7 dermatome numbness

weak grasping less than 1hr

07.8.19 4 Abd 45°, Flex 110° VAS 10 2hrs

07.8.21 6 Abd 60°, Flex 110° VAS 8~9 4hrs

reduction of muscle relaxant and narcotic analgesic, discontinuance

of Anti-inflammatory enzymes

07.8.24 9 Abd 60°, Flex 110° VAS 7

able to grasp 4hrs

07.8.26 11 Abd 60°, Flex 120° VAS 5 4hrs

07.8.30 15 Abd 60°, Flex 120° VAS 6 2hrs

07.9.05 20 Abd 80°, Flex 120°

Drop arm test(-) VAS 5 4hrs discontinuance of muscle relaxant

and narcotic analgesic

07.9.10 25 Abd 80°, Flex 120° VAS 5 3hrs

07.9.12 27 Abd 80°, Flex 120° VAS 4 4hrs

07.9.14 29 Abd 80°, Flex 120° VAS 2 5hrs

Table 3.

Passive

Flexion 180°

Active

Flexion 90°

Extension 45° Extension 10°

Abduction 180° Abduction 90°

Adduction 30° Adduction 10°

External rotation 75° External rotation 30°

Internal rotation 90° Internal rotation 30°

Table 4.

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(2)

CBC, LFT, BUN, Creatinine, T-cholesterol, HDL cholesterol, TG, ALP, T-biliubin, Albumin, UA,

. T-protein 6.5 (3) Shoulder MRI (Fig. 4) (Fig. 5)

Increased fluid in right subacromial subdeltoid bursa with linear calcification.

Thickening and partial discontinuity in right supraspinatus tendon insertion site.

Partial tear in right supraspinatus tendon critical site.

No remarkable in right biceps brachii long head tendon and subscapularis & infraspinatous and teres minor tendon.

IMP)Partial tear in right supraspinatus tendon critical site & calcific bursitis in right shoulder.

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HOD Shoulder ROM Shoulder Pain Neck Pain Sleep

07.9.21 1 Adbuction(Abd) 90°, painful, Flexion(Flex) 90°

Pain on anterior deltoid region VAS 10

Rt. upper Trapezius &

post neck pain

frequently awakened by night

pain

07.9.27 7 Abd 120°, Flex 120° VAS 8 VAS 9 less awakened

07.9.28 8 Abd 150°, Flex 150° VAS 6~7

less pain in lying VAS 8 much better

07.10.1 12 Abd 150°, less painful Flex 180°

VAS 6~7

able to fasten her hair VAS 8 slept well

07.10.4 15 Abd 180°, little painful Flex 180°

Drop arm test(-) VAS 5 VAS 6 awakened

time to time 07.10.10 21 Abd 180°, little painful, Flex

180° VAS 5 VAS 5 slept well

07.10.17 28 Abd 180°, Flex 180° VAS 5

pain on side lying only VAS 5 pain after rising, no night pain 07.10.24 35 Abd 180°, Flex 180°

sometimes painful VAS 5 VAS 3 slept well

07.10.30 41 Abd 180°, Flex 180° VAS 4 VAS 3 slept well

Table 5.

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