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Shoulder pain MRi

Senthil Nathan Sambandam, Mukesh Atturu
INTRODUCTION: Septic arthritis of the shoulder is uncommon in adults. It is a surgical emergency as joint destruction occurs rapidly and can lead to significant morbidity and mortality. Accurate diagnosis can be particularly challenging in patients with underlying liver disease. MRI is a useful adjunct in early detection of atypical causes of shoulder pain. CASE REPORT: A 43 years old male came to our outpatient department with complaints of pain and stiffness of his left shoulder...
April 2016: Journal of Orthopaedic Case Reports
Christoph Schleich, Falk Miese, Anja Müller-Lutz, Johannes Boos, Joel Aissa, Adrian Nasca, Frank Zaucke, Tamara Bostelmann, Lars Schimmöller, Bernd Bittersohl, Hans-Jakob Steiger, Gerald Antoch, Richard Bostelmann
The study was performed to preoperatively assess the cartilage integrity of cervical intervertebral discs (IVDs) using Delayed Gadolinium-Enhanced Magnetic Resonance Imaging of Cartilage (dGEMRIC). Therefore, 53 cervical intervertebral discs of nine preoperative patients with neck and shoulder/arm pain scheduled for discectomy (five females, four males; mean age: 47.1 ± 8.4 years; range: 36-58 years) were included for biochemical analysis in this retrospective study. The patients underwent 3T magnetic resonance imaging (MRI) including biochemical imaging with dGEMRIC and morphological, sagittal T2 weighted (T2w) imaging...
October 4, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
G B Mahadewa Tjokorda, Golden Nyoman, Maliawan Sri, Mizuno Junichi
This report presents two cases of cervicobrachialgia and radiculopathy due to multiple cervical herniated discs and spur formation that dealt with anterior cervical discectomy and fusion (ACDF) using different titanium interbody cages. The description of the clinical presentation, magnetic resonance imaging (MRI) appearances and management strategy are discussed. Both cases showed chronic neck pain and radiating pain from the shoulder to the arm. They had a history of blurry vision, cluster head ache, weakness, and numbness on the shoulder for 2 years...
October 2016: Asian Journal of Neurosurgery
Christelle Pons, Dinomais Mickael, Franck Fitoussi, Marie-Charlotte D'Anjou, Mélanie Porte, Emilie Rumilly, Nathaly Quintero, Philippe Violas, Sylvain Brochard
OBJECTIVE: In children with obstetrical brachial plexus palsy (OBPP), shoulder musculoskeletal deformity is the main cause of morbidity, with a loss of range of shoulder motion, pain and a reduction in social participation. Some uncontrolled studies show that early injections of botulinum toxin (BTI) in the internal shoulder rotator muscles (which cause the deformity) are one of the most promising treatments for the prevention of bony deformity. The main objective of this study will be the evaluation of the effectiveness of BTI in the internal shoulder rotator muscles at the age of 6 months in preventing an increase in posterior subluxation of the glenohumeral joint in babies with OBPP (evaluated at the ages of 5 and 12 months), compared with a placebo...
September 2016: Annals of Physical and Rehabilitation Medicine
Justin D Orr, John C Dunn, Kenneth A Heida, Nicholas A Kusnezov, Brian R Waterman, Philip J Belmont
INTRODUCTION: Structural fresh osteochondral allograft transfer is an appropriate treatment option for large osteochondral lesions of the talus (OLTs), specifically lesions involving the shoulder of the talus. Sparse literature exists regarding functional outcome following this surgery in high-demand populations. MATERIALS AND METHODS: Over a 2-year period, a single surgeon performed 8 structural allograft transfers for treatment of large OLTs in an active duty US military population...
September 13, 2016: Foot & Ankle Specialist
Michael Day, M Phil, Richard A McCormack, Samir Nayyar, Laith Jazrawi
INTRODUCTION: Ultrasonography offers a fast and inexpensive method to evaluate the rotator cuff in the office setting. However, the accuracy of ultrasound is highly user dependent. The purpose of this study is to investigate the learning curve of an orthopaedic surgeon in using ultrasound to diagnose rotator cuff tears. METHODS: A sports medicine fellowship trained orthopaedic surgeon was taught how to perform and interpret an ultrasound examination of the shoulder by a musculoskeletal radiologist...
September 2016: Bulletin of the Hospital for Joint Diseases
Tomohito Hagi, Tomoki Nakamura, Ayumu Yokoji, Akihiko Matsumine, Akihiro Sudo
The present study reports a case of medullary metastasis without lung metastasis that occurred as a result of a malignant peripheral nerve sheath tumor (MPNST). An 81-year-old woman presented with a MPNST in the left brachial plexus, arising from the cervical nerve root. The patient underwent carbon ion radiotherapy; however, tumor recurrence was identified in the left shoulder. Subsequently, the patient underwent wide excision. Three weeks subsequent to surgery, imbalance and dysarthria developed suddenly...
September 2016: Oncology Letters
Derek Friedrich Petrus van Deurzen, Vanessa Antoinet Bernice Scholtes, Nienke Willemien Willigenburg, Navin Gurnani, Lukas Pieter Eduard Verweij, Michel Pieter Jozef van den Bekerom
BACKGROUND: Optimal treatment of the diseased long head of the biceps (LHB) tendon during rotator cuff repair remains a topic of debate: tenotomy or tenodesis. A recent meta analysis revealed no difference in strength or functional outcome between treatments. The included studies varied in methodological quality, and only two were randomized controlled trials (RCTs). As strong evidence in favor of either tenotomy or tenodesis is still lacking, we designed this randomized controlled trial to compare functional outcomes after tenotomy and tenodesis when performed in adjunct to arthroscopic rotator cuff repair...
2016: BMC Musculoskeletal Disorders
Ahmed Shams, Mohamed El-Sayed, Osama Gamal, Waled Ewes
OBJECTIVE: Rotator cuff tears are one of the most common causes of chronic shoulder pain and disability. They significantly affect the quality of life. Reduced pain and improved function are the goals of conventional therapy, which includes relative rest, pain therapy, physical therapy, corticosteroid injections and surgical intervention. Tendons have a relative avascular nature; hence, their regenerative potential is limited. There is some clinical evidence that the application of autologous platelets may help to revascularize the area of injury in rotator cuff pathologies...
August 20, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Hideyuki Sasanuma, Hideharu Sugimoto, Akifumi Fujita, Yuji Kanaya, Yuki Iijima, Toshihiro Saito, Katsushi Takeshita
BACKGROUND: The purpose of this study was to evaluate the effectiveness of current techniques for dynamic 3-dimensional magnetic resonance imaging (MRI) in the diagnosis of idiopathic severe frozen shoulder (FS). MATERIALS AND METHODS: Subjects consisted of 5 healthy volunteers and 16 patients with idiopathic severe FS. We defined severe idiopathic FS as follows: range of motion ≤100° in forward flexion, ≤10° in external rotation, and ≤L5 in internal rotation...
August 15, 2016: Journal of Shoulder and Elbow Surgery
Liang Zhao, Kaiyu Zhou, Yimin Hua, Yifei Li, Dezhi Mu
INTRODUCTION: Pigmented villonodular synovitis (PVNS) is a rare, benign proliferative disorder of the synovial membrane that typically presents in adults and affects a single joint. Multifocal PVNS is very rare, particularly in childhood. We reported a rare case of multifocal PVNS affecting over 20 joints in a child. CLINICAL PROCEDURE: A 7-year-old female patient had a 6-month history of multifocal joints swelling with mild pain. She was diagnosed as polyarticular juvenile idiopathic arthritis at a local hospital...
August 2016: Medicine (Baltimore)
Sang-Jin Shin, Jae-Hoon Jeong, Yoon Sang Jeon, Rag Gyu Kim
INTRODUCTION: The purpose of this study was to introduce a novel arthroscopic transtendon anatomic repair technique that spares the intact bursal-sided tendon in articular-sided partial-thickness rotator cuff tears (PTRCT) and to present shoulder functional outcomes in patients with symptomatic articular-sided PCRCT that involves more than 50 % of its thickness after arthroscopic repair using a novel technique. MATERIALS AND METHODS: Eighteen patients with symptomatic articular-sided PCRCT involving more than 50 % of the tendon's thickness underwent arthroscopic repair using a devised technique...
August 6, 2016: Archives of Orthopaedic and Trauma Surgery
C Dejaco, E L Matteson, F Buttgereit
Polymyalgia rheumatica (PMR) is the most common autoimmune inflammatory disease in older persons with an average age of onset of 73 years. Typical symptoms include acute or subacute bilateral shoulder pain with severe stiffness and often neck and bilateral hip pain. Giant cell arteritis (GCA) occurs in approximately 20 % of cases and up to two thirds of patients with GCA have symptoms of PMR. There are many disease which mimic PMR, elderly onset rheumatoid arthritis is frequently misdiagnosed as PMR. Although there are no specific laboratory tests, C‑reactive protein and erythrocyte sedimentation rates are elevated in over 90 % of patients...
September 2016: Zeitschrift Für Rheumatologie
Chenlong Yanga, Guang Lib, Jingyi Fangc, Hai Liua, Bao Yanga, Yulun Xua
BACKGROUND: Spinal syphilitic gumma is an unusual presentation of neurosyphilis, with a limited number of cases reported in the literature. Owing to its extreme rarity, the diagnosis and treatment of spinal syphilitic gumma as well as the relevant prognosis have not been outlined. CASE DESCRIPTION: We present a case of a 65-year-old female patient presenting with progressive sensorimotor disturbance of the extremities after a history of neck-shoulder-back pain. Serological tests revealed a presence of syphilis...
July 21, 2016: World Neurosurgery
Christine Tempelaere, Jérome Pierrart, Marie-Martine Lefèvre-Colau, Valérie Vuillemin, Charles-André Cuénod, Ulrich Hansen, Olivier Mir, Wafa Skalli, Thomas Gregory
BACKGROUND: MRI is the standard methodology in diagnosis of rotator cuff diseases. However, many patients continue to have pain despite treatment, and MRI of a static unloaded shoulder seems insufficient for best diagnosis and treatment. This study evaluated if Dynamic MRI provides novel kinematic data that can be used to improve the understanding, diagnosis and best treatment of rotator cuff diseases. METHODS: Dynamic MRI provided real-time 3D image series and was used to measure changes in the width of subacromial space, superior-inferior translation and anterior-posterior translation of the humeral head relative to the glenoid during active abduction...
2016: PloS One
Mona Schmidt, Sandra Breyer, Ulrike Löbel, Sinef Yarar, Ralf Stücker, Kurt Ullrich, Ingo Müller, Nicole Muschol
BACKGROUND: Hematopoietic stem cell transplantation (HSCT) is the treatment of choice for young Hurler patients. Despite halting of neurocognitive decline and improvement of life expectancy, the beneficial effect on the skeletal system is limited. As orthopedic complications are one of the most disabling factors following HSCT, this points to the need for new treatment strategies. The study summarizes musculoskeletal manifestations in 19 transplanted Hurler patients. METHODS: Data were obtained retrospectively...
2016: Orphanet Journal of Rare Diseases
U Dorn, F Landauer, T Hofstaedter
Gluteal tendinopathy as well as partial and full-thickness tears of gluteal tendons (gluteus minimus and/or medius tendon) were underestimated as a cause of chronic pain in the past, and treatment was most commonly based on the diagnosis of trochanteric bursitis. Tendinous pathologies can either stay asymptomatic or cause pain and muscular dysfunction, not necessarily being associated with osteoarthritis of the hip 1. As the terminus "rotator cuff tear of the hip" was published in 1997 2, its aetiopathogenesis was reconsidered, resulting in improvements in diagnosis and treatment...
June 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
Frank Buttgereit, Christian Dejaco, Eric L Matteson, Bhaskar Dasgupta
IMPORTANCE: Polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) are related inflammatory disorders occurring in persons aged 50 years and older. Diagnostic and therapeutic approaches are heterogeneous in clinical practice. OBJECTIVE: To summarize current evidence regarding optimal methods for diagnosing and treating PMR and GCA. EVIDENCE REVIEW: MEDLINE, EMBASE, and Cochrane databases were searched from their inception dates to March 30, 2016...
June 14, 2016: JAMA: the Journal of the American Medical Association
Shreedhar Archik, Saurav Narayan Nanda, Sanjay Tripathi, Ashlesh Choudhari, Harshada Rajadhyaksha
INTRODUCTION: Isolated coracoid fractures are rare and few scattered cases are reported in literature. Coracoid fractures can be missed and the treatment for coracoid process fractures is still controversial. The case presented here is of an isolated coracoid process fracture which was treated surgically. CASE REPORT: A 15-years old male presented after 4 days of injury complaining of persistent pain in the right shoulder following a jerk during bowling. Physical examination revealed tenderness in the left shoulder...
January 2016: Journal of Orthopaedic Case Reports
Yoshimasa Mori, Toshiki Kawamura, Yukihiko Ohshima, Arisa Takeuchi, Toshie Mori, Tuneo Ishiguchi
A case of cervical (C) spinal intramedullary metastasis and multiple small brain metastases from papillary thyroid carcinoma was presented. Spinal metastasis caused posterior neck and left shoulder pain, dysesthesia in both legs, and motor weakness in both legs and left arm, though the brain metastases were asymptomatic. Both the spinal and brain metastases were successfully treated by frameless stereotactic radiotherapy (SRT)/stereotactic radiosurgery (SRS). The patient's symptoms were almost entirely relieved within two months...
2016: Curēus
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