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Shoulder pain MRi

Simond Jagernauth, Reece Alexander James Clough, Ali Noorani, Muaaze Ahmad
We present a rare case of a subscapularis pyomyositis in a 38-year-old woman and examine the diagnostic and surgical challenges posed. History and examination features were similar to that of septic shoulder arthritis without overlying features of warmth or erythema. Serological markers revealed a C-reactive protein of 221 mg/L and white cell count of 11.1×109 /L. A dry shoulder aspirate was obtained. Contrast-enhanced MRI demonstrated a peripheral rim-enhancing lesion within the subscapularis muscle belly with lack of central enhancement...
March 16, 2018: BMJ Case Reports
Andrew T Pennock, Jerry Dwek, Emily Levy, Philip Stearns, John Manning, M Morgan Dennis, Amanda Davis-Juarez, Tracey Bastrom, Kenneth S Taylor
Background: Youth baseball is extremely popular in the United States, but it has been associated with shoulder pain and injury. The incidence of shoulder abnormalities in this athletic population has yet to be defined. Purpose: To examine abnormalities noted on magnetic resonance imaging (MRI) in the shoulders of asymptomatic Little League baseball players and to correlate these findings with the players' throwing history and physical examinations. Study Design: Case-control study; Level of evidence, 3...
February 2018: Orthopaedic Journal of Sports Medicine
Egbert J D Veen, Cornelia M Donders, Robin E Westerbeek, Rosalie P H Derks, Ellie B M Landman, Cornelis T Koorevaar
BACKGROUND: A magnetic resonance imaging (MRI) scan of the shoulder can have added value in diagnosing symptomatic osteoarthritis of the acromioclavicular (AC) joint. Specific MRI signs have been recognized but not analyzed extensively before. This study aims to identify predictive MRI signs in patients with symptomatic AC osteoarthritis. METHODS: The MRI scans of 70 patients with symptomatic AC osteoarthritis were compared with those of 70 patients with subacromial pain syndrome and no clinical signs of symptomatic AC osteoarthritis...
February 28, 2018: Journal of Shoulder and Elbow Surgery
Saya Horiuchi, Taiki Nozaki, Atsushi Tasaki, Sachiko Ohde, Gautam A Deshpande, Jay Starkey, Takeshi Hara, Nobuto Kitamura, Hiroshi Yoshioka
OBJECTIVE: The aims of this study were to compare isotropic 3-dimensional fat-suppressed T2-weighted fast spin echo (FSE) imaging (T2FS) with 2-dimensional fat-suppressed proton-density-weighted FSE imaging (2D-PDFS) and evaluate feasibility of isotropic 3-dimensional FSE shoulder imaging at 3-T magnetic resonance imaging (MRI). METHODS: Seventy-eight patients who underwent shoulder MRI were evaluated. Three-dimensional T2FS and 2D-PDFS were qualitatively graded for delineation of anatomic structures...
February 27, 2018: Journal of Computer Assisted Tomography
W Pepke, M Brunner, R Abel, H Almansour, H J Gerner, A Hug, F Zeifang, Y Kentar, T Bruckner, M Akbar
QUESTION: Shoulder pain and rotator cuff tears are highly prevalent among wheelchair dependent individuals with paraplegia. The purpose of this study was to identify potential risk factors associated with the development of rotator cuff tears in this population. METHODS: A total of 217 wheelchair dependent individuals with paraplegia were included in this cross-sectional study (level of evidence III). The mean age of this population was 47.9 years and the mean duration of wheelchair dependence was 24...
February 27, 2018: Der Orthopäde
Maria Francesca Gicchino, Mario Diplomatico, Carmela Granato, Daniela Capalbo, Pierluigi Marzuillo, Alma Nunzia Olivieri, Emanuele Miraglia Del Giudice
BACKGROUND: Chronic recurrent multifocal osteomyelitis (CRMO), also known as chronic nonbacterial osteomyelitis, is a rare, noninfectious inflammatory disorder that causes multifocal bone lesions with swelling and pain. Lytic and sclerotic bone lesions could be found on X-ray. Short tau inversion recovery magnetic resonance imaging (STIR MRI) shows bone marrow oedema, bone expansion, lytic areas and periosteal reaction. CRMO is characterized by periodic exacerbations and remissions of unclear/unknown pathogenesis...
February 17, 2018: Italian Journal of Pediatrics
Cecilie P Schrøder, Kirsten Lundgreen, Rune Kvakestad
BACKGROUND: Paralabral cysts emanating from posterosuperior labral tears may compress the suprascapular nerve and induce neuropathy. This study prospectively assessed patients with labral tears and symptomatic paralabral cysts treated with isolated labral repair. Pain relief, time to cyst resolution, reversibility of muscular edema, atrophy, fatty infiltration, and bone erosion were evaluated. METHODS: Forty-seven patients with symptomatic posterosuperior paralabral cysts were treated with isolated labral repair...
February 13, 2018: Journal of Shoulder and Elbow Surgery
Chouhan Devendra Kumar, John Rakesh, Bansal Tungish, Dhillon Mandeep Singh
Background: Multiple reports of congenitally absent long head of biceps tendon (LHBT) have been reported in the literature. However, there is no consensus on the clinical implications of this relatively rare entity. Study Purpose: To systematically review and analyze all studies which have reported absence of LHBT. Methods: PubMed and EMBASE databases were searched. Also, a secondary search was performed by pearling the bibliography of all the full-text articles obtained...
July 2017: Muscles, Ligaments and Tendons Journal
James D Wylie, Sean Baran, Erin K Granger, Robert Z Tashjian
Background: Rotator cuff repair (RCR) leads to improved patient outcomes, which may or may not coincide with biological healing of the tendon. Many patient factors may play a role in subjective and objective patient outcomes of surgery. Purpose: To evaluate the effect of various patient factors and tendon healing on range of motion, strength, and functional outcomes after arthroscopic RCR. Study Design: Case-control study; Level of evidence, 3...
January 2018: Orthopaedic Journal of Sports Medicine
Peter N Chalmers, Erin Granger, Richard Nelson, Minkyoung Yoo, Robert Z Tashjian
BACKGROUND: The purpose of this study was to simultaneously examine costs, functional outcomes, and tendon healing after arthroscopic rotator cuff repair. METHODS: This was a retrospective, single-surgeon, single-hospital study. Pre- and postoperative Simple Shoulder Test (SST), visual analog scale (VAS) pain, and American Shoulder and Elbow Surgeons (ASES) scores, and postoperative magnetic resonance images (MRIs) were obtained. Direct costs were derived using a unique, validated tool...
January 20, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Ahmad Bakhtiar Md Radzi, Soek-Siam Tan
RATIONALE: We report a rare case of hepatocellular carcinoma (HCC) with metastases to the mandible and coracoid process of scapula without evidence of lung involvement. PATIENTS CONCERNS: The patient was diagnosed with HCC, presented 5 months later with right lower tooth pain, swelling over the right mandible area and right shoulder pain. DIAGNOSES: Histopathological examination of mandible showed findings suggestive of metastatic HCC. Magnetic resonance imaging (MRI) of the right shoulder revealed findings of irregular enhancing lesion at the right coracoid process causing erosion of the coracoid process...
January 2018: Medicine (Baltimore)
Susan C Lee, Danielle Williams, Yoshimi Endo
PURPOSE OF REVIEW: The purposes of this review were to provide an overview of the current practice of evaluating the postoperative rotator cuff on imaging and to review the salient imaging findings of the normal and abnormal postoperative rotator cuff, as well as of postoperative complications. RECENT FINDINGS: The repaired rotator cuff frequently appears abnormal on magnetic resonance imaging (MRI) and ultrasound (US). Recent studies have shown that while the tendons typically normalize, they can demonstrate clinically insignificant abnormal imaging appearances for longer than 6 months...
March 2018: Current Reviews in Musculoskeletal Medicine
Ross Mathiasen, Christopher Hogrefe
PURPOSE OF REVIEW: To provide a primary care perspective regarding the evaluation and management of shoulder pain and rotator cuff tears. RECENT FINDINGS: In the primary care setting, rotator cuff pathology is commonly encountered. Information regarding the risks of oral medications for the management of the associated pain keeps mounting. Partial-thickness rotator cuff tears remain difficult to diagnose with a single imaging modality. Musculoskeletal education in medical schools and non-orthopaedic residency and fellowship training programs continues to be an area for additional improvement...
January 19, 2018: Current Reviews in Musculoskeletal Medicine
Ahmed A Elsheikh, Rohan S Pinto, Alpesh Mistry, Simon P Frostick
Melorheostosis is a rare, nonhereditary, benign, mesenchymal condition of unknown aetiology affecting the bones and surrounding tissues. A male patient complaining of left shoulder pain, swelling, and mildly limited range of motion has an exclusive combination of the classic dripping wax lesion in the scapula and the myositis ossificans-like lesion in the deltoid muscle; this combination is the first to be reported in the shoulder. Both lesions showed typical findings of melorheostosis in radiographs, CT, MRI, and bone scan...
2017: Case Reports in Orthopedics
Hongquan Wen, Xin Wang, Wenbo Liao, Weijun Kong, Jianpu Qin, Xing Chen, Hai Lv, Thor Friis
The objective was to investigate the effective and safe range of paramedian CDH by percutaneous posterior full-endoscopy cervical intervertebral disc nucleus pulposus resection (PPFECD) to provide a reference for indications and patient selection. Sixteen patients with CDH satisfied the inclusion criteria. Before surgery the patients underwent cervical spine MRI, and the distance between the dural sac and herniated disc was measured. An assessment was performed by MRI immediately after surgery, measuring the distance between dural sac and medial border of discectomy (DSMD)...
2017: BioMed Research International
I R Águila-Ledesma, J L Córdova-Fonseca, O Medina-Pontaza, D A Núñez-Gómez, C Calvache-García, J M Pérez-Atanasio, R Torres-González
Pathology related to the rotator cuff remains among the most prevalent musculoskeletal diseases. There is an increasing need for imaging studies (MRI, US, arthroscopy) to test the diagnostic performance of the medical history and physical examination. OBJECTIVE: To prove the diagnostic value of a clinical-radiographic predictive model to find complete ruptures of the rotator cuff. MATERIAL AND METHODS: Descriptive, observational, prospective, transversal and analytical study...
May 2017: Acta Ortopédica Mexicana
Elisabeth R Garwood, Gregory S Mittl, Michael J Alaia, James Babb, Soterios Gyftopoulos
PURPOSE: Characterize the clinical utility of diagnostic shoulder imaging modalities commonly used in the outpatient workup of shoulder pain. MATERIALS/METHODS: Retrospective review of adults imaged for outpatient shoulder pain from 1/1/2013 to 9/1/2015. To be categorized as "useful", a study had to meet one of the following criteria: change the clinical diagnosis or treatment plan, provide a final diagnosis, or guide definitive treatment. A utility score was assigned to each study based on the number of utility criteria met (range 0-4)...
November 4, 2017: Current Problems in Diagnostic Radiology
Andreas Knudsen, Carsten Thomsen, Lothar Wiese
We describe the clinical course of a 60-year old male admitted with Staphylococcus aureus bacteremia and back-pain. The patient was suspected of having spondylitis and treated as such with antibiotics; however, both fluorine-18 fluoro-2-deoxy-d-glucose (18F-FDG) positron-emission tomography and magnetic resonance imaging (MRI) with iv contrast showed significant inflammation of muscles and subcutaneous soft tissue in relation to the patients back and left shoulder, but no signs of the working diagnosis of spondylitis...
November 30, 2017: Diagnostics
Knut E Aagaard, Jonas Hänninen, Fikri M Abu-Zidan, Karl Lunsjö
BACKGROUND: Early diagnosis of traumatic acute full-thickness rotator cuff tears (FTRCT) is important to offer early surgical repair. Late repairs following fatty infiltration of the rotator cuff muscles have less favorable results. We think that physical therapists are valuable diagnosticians in a screening process. The objective of this study was to evaluate the usefulness of physical therapists as first-line diagnosticians in detecting acute traumatic FTRCT. METHODS: Between November 2010 and January 2014, 394 consecutive patients having an age between 18 and 75 years who sought medical care because of acute shoulder trauma with acute onset of pain, limited abduction and negative plain radiographs were included in the study...
November 29, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Elisabeth Kvalvaag, Masoud Anvar, Anna Cecilia Karlberg, Jens Ivar Brox, Kaia Beck Engebretsen, Helene Lundgaard Soberg, Niels Gunnar Juel, Erik Bautz-Holter, Leiv Sandvik, Cecilie Roe
BACKGROUND: Previous studies on shoulder patients have suggested that the prevalence of rotator cuff or bursa abnormalities are weakly related to symptoms and that similar findings are often found in asymptomatic persons. In addition, it is largely unknown whether structural changes identified by magnetic resonance imaging (MRI) affect outcome after treatment for shoulder pain. The purpose of this study was therefore to evaluate the presence of structural changes on MRI in patients with subacromial pain syndrome and to determine to what extent these changes are associated with symptoms and predict outcome after treatment (evaluated by the Shoulder Pain and Disability Index (SPADI))...
November 21, 2017: BMC Musculoskeletal Disorders
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