Object: pathological processes in the shoulder girdle region in patients with shoulder pain syndrome, age-related changes in the structure of the periarticular tissues of the shoulder joint in practically healthy volunteers. Aim: improve the diagnosis of pain syndromes in the shoulder girdle area by studying the features of the anatomical structures of the shoulder joint in healthy individuals and patients of different ages based on the analysis of the results of ultrasound, electrophysiological and biochemical examinations. Methods: clinical, ultrasound, radiological, electrophysiological, biochemical, statistical. New knowledge about the average capsule thickness of joint, tendons, ligaments and muscles in the shoulder joint region, as well as the peculiarities of these indices separately for men and women in different age groups were obtained. For the first time, the ultrasound criteria showed that periarticular tissues of the shoulder joints in healthy volunteers did not differ by more than 4 %, and the asymmetry coefficient was more than 0.96 in all age subgroups. Age-related changes, which did not lead to the clinical symptoms’ appearance, occurred symmetrically in both joints and their manifestations were observed in 10 % of surveyed at the age of 31-40 years, in 32-41 % – at the age of 41-50 years, in 45-65 % – at the age of 51-60 years. It was first determined that in patients with osteochondrosis of the cervical and thoracic spine with pain in the shoulder region, the difference in capsule thickness of rotator cuff tendons, ligaments and muscles of the unaffected and affected shoulder joints was less than 5 %, and the asymmetry coefficient was more than 0.95, which indicated the absence of pathological changes in them. On the contrary, in patients with scapulohumeral pain syndrome of unclear etiology, the thickness difference of these anatomical structures of the unaffected and affected shoulder joints was more than 5 %, and the asymmetry coefficient was less than 0.95, which indicated pathological changes in them. For the first time, it has been proved that, in patients with scapulohumeral pain syndrome, nosological types differed by lesions of different anatomic structures, and manifested: in the subgroup with tendons’ tendinitis, most often, by lesions of the supraspinatus muscle’s tendon (92.1 %), long head of biceps brachii (71.1 %) and infraspinatus (52.6 %) muscles; with calcific tendinitis – in 100 % by lesion of supraspinatus muscle’s tendon; with arthritis of acromioclavicular joint – by pathological changes in the structure of acromioclavicular joint, with adhesive capsulitis – by pathological changes in the capsule and tendon of the long head of biceps brachii muscle. The differential diagnostics scheme of different nosological types of scapulohumeral pain syndrome has been developed, which allows, at the initial stage of clinical examination of patients, to separate those without structural changes in the periarticular tissues of the shoulder joint and the others – having pain in shoulder girdle region, in order to select specific treatment policy. The scheme of anatomic structures lesions in the shoulder joint under conditions of scapulohumeral pain syndrome makes it possible to perform a differential diagnosis between various nosological types, which will facilitate the choice of adequate treatment policy and, accordingly, will improve the treatment quality of patients. The results of the study were introduced into the clinical practice of the SI "Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine", KNP "City Clinical Hospital of Emergency and Emergency Medical Care named after Prof. A.I. Meshchaninov", LLC "Medical Center for Physical Rehabilitation and Sports Medicine "KINESIO", in the educational process of the Department of Traumatology and Orthopedics of the Kharkov Medical Academy of Postgraduate Education of the Ministry of Health of Ukraine. Тraumatology and Orthopaedics.
