Neer sign

INTRODUCTION: Subacromial impingement syndrome (SAIS) is one cause of shoulder pain and encompasses a spectrum of pathologies and is not an isolated entity. PRESENTATION OF CASE: We present a rare case where a 40 year old male presented with a 3 year history of right shoulder tip pain with limited abduction to 30°, external rotation to 45°, preserved internal rotation and forward flexion and a painful arc with positive Neers and Hawkins-Kennedy signs for impingement consistent with SAIS...

Although the teres minor is often overlooked in a normal shoulder, it becomes a key component in maintaining shoulder function when other rotator cuff tendons fail. The teres minor maintains a balanced glenohumeral joint and changes from an insignificant to the most significant external rotator in the presence of major rotator cuff pathology. The presence or absence of the teres minor provides prognostic information on the outcomes of reverse total shoulder arthroplasty and tendon transfers. Clinical tests include the Patte test, the Neer dropping sign, the external rotation lag sign, and the Hertel drop sign...

CONTEXT: Shoulder pain and dysfunction are common, with patients presenting complaints to both primary and orthopaedic physicians. History and physical examination remain essential to creating a differential diagnosis, even as noninvasive imaging has improved. EVIDENCE ACQUISITION: Literature was obtained through keyword searches based on the pathology in question (eg, rotator cuff) and the keywords physical examination using PubMed from January 1, 1980, through September 20, 2017...

UNLABELLED: 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...

BACKGROUND: Despite being a common orthopedic injury, the optimal management of proximal humeral fractures remains a topic of debate. Although intramedullary nails have been used to treat these fractures, several complications have been reported with older nail devices. We describe our surgical technique and aim to evaluate the early functional and radiological outcomes of displaced Neer's two- to four-part proximal humeral fractures undergoing fixation with a contemporary straight intramedullary nail...

BACKGROUND: Recent studies have confirmed the existence of neuropathic pain (NeP) components in patients with musculoskeletal disorders. However, the presence of NeP in patients with rotator cuff tears has not been investigated thus far. Therefore, we studied the prevalence of NeP and the prognostic factors for NeP in patients with rotator cuff tears. METHODS: Data were collected from 110 patients with rotator cuff tears, diagnosed by physical examination and magnetic resonance imaging, who attended an outpatient clinic between August 2013 and August 2014...

BACKGROUND: The internet has an increasing role in both patient and physician education. While several recent studies critically appraised the quality and accuracy of web-based written information available to patients, no studies have evaluated such parameters for open-access video content designed for provider use. QUESTIONS/PURPOSES: The primary goal of the study was to determine the accuracy of internet-based instructional videos featuring the shoulder physical examination...

Objective: Compare the efficacy of two approaches to ultrasound-guided subacromial-subdeltoid bursa injections and to assess whether shoulder impingement tests acts as a predictive factor for efficacy of the injection. Design: Retrospective chart review and telephone survey of 40 patients who received ultrasound-guided subacromial-subdeltoid injections using 4cc 1% lidocaine and 80 mg methylprednisolone from January 2011 to December 2011. Outcome measures included: number of positive shoulder impingement tests (Neer, Hawkin, Yocum), pain level (10-Point VAS) and duration of pain relief (< 4 weeks, 4-12 weeks, > 12 weeks)...

Testing the hearing abilities of marine mammals under water is a challenging task. Sample sizes are usually low, thus limiting the ability to generalize findings of susceptibility towards noise influences. A method to measure harbor porpoise hearing thresholds in situ in outdoor conditions using auditory steady state responses of the brainstem was developed and tested. The method was used on 15 live-stranded animals from the North Sea during rehabilitation, shortly before release into the wild, and on 12 wild animals incidentally caught in pound nets in Denmark (inner Danish waters)...

BACKGROUND: The supraspinatus tendon is the most commonly affected tendon in rotator cuff tears. Early detection of a supraspinatus tear using an accurate physical examination is, therefore, important. However, the currently used physical tests for detecting supraspinatus tears are poor diagnostic indicators and involve a wide range of sensitivity and specificity values. Therefore, the aim of this study was to establish a new physical test for the diagnosis of supraspinatus tears and evaluate its accuracy in comparison with conventional tests...

PURPOSE: There is a paucity of data detailing management of anterior capsular redundancy (ACR) when using the Latarjet procedure for unidirectional instability. This study aimed to describe the surgical management and to assess the clinical profile of patients presenting with anterior capsular redundancy [ACR(+)] with anterior shoulder instability. METHODS: Seventy-seven patients who had a Latarjet procedure were followed for a 55-month period. Per-operative ACR was assessed during surgery...

BACKGROUND: Intratendinous tears of the rotator cuff are rare, and little has been written about them. PURPOSE: To investigate the prevalence and clinical and radiological outcomes of arthroscopically confirmed intratendinous tears treated with transtendon suture bridge repair. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Included in the study were 33 patients (16 male, 17 female; mean age, 53.4 years) with arthroscopically confirmed intratendinous tears treated with transtendon suture bridge repair from March 2006 to July 2012...

BACKGROUND: It is unknown which combination of patient information and clinical tests might be optimal for the diagnosis of rotator cuff tears. This study aimed to determine the diagnostic value of nine individual clinical tests for evaluating rotator cuff tear and to develop a prediction model for diagnosing rotator cuff tear. METHODS: This prospective cohort study included 169 patients with shoulder complaints. Patients who reported a previous shoulder dislocation were excluded from the analysis (N = 69)...

OBJECTIVE: Primary endoprosthetic joint replacement in non-reconstructable proximal humeral fracture in the elderly. Alternative to fracture hemi-endoprosthesis with resorption of tuberosities and secondary rotator cuff insuffiency which leads to unsatisfying functional results. INDICATIONS: Non-reconstructable proximal humeral fracture in mainly old patients with osteoporotic bone, multifragment tuberosity fracture and degenerative rotator cuff lesion. CONTRAINDICATIONS: Patient not fit for surgery, pre-existing shoulder infection or sepsis, severe general medical condition, nerve damage (axillay nerve, Plexus) SURGICAL TECHNIQUE: Deltopectoral or delta-split approach...

OBJECTIVES: To evaluate the short-term efficacy of muscle shortening manoeuvre (MSM), by inducing an increase in strength of the shoulder muscles, for the treatment of shoulder impingement syndrome (SIS). METHODS: Sixty subjects (mean age: 58.6 years) with SIS were assigned to one of 3 different treatment interventions: 1) MSM: a series of fast accelerations in the upward direction was applied to the upper limb that was also submitted to forces acting in the opposite direction (added mass); 2) traditional physiotherapeutic technique: scapulothoracic gliding; 3) simple traction: the added mass was applied to the limb without the series of fast accelerations...

BACKGROUND: There has been no study using magnetic resonance arthrography (MRA) to compare clinical features and structural integrity after arthroscopic repair of bursal and articular side partial-thickness rotator cuff tears (PTRCTs). HYPOTHESIS: The 2 groups studied, which consisted of patients who underwent arthroscopic repair for either the articular side or the bursal side, would show significant improvement in overall outcomes after surgery, even though clinical outcomes and structural integrity would not be significantly different...

PURPOSE: Subacromial decompression is the standard surgical treatment of subacromial impingement syndrome. Unsatisfactory results have been reported for concomitant lesions as well as inadequate diagnosis. We sought to determine the predictive value of the preoperative examination for the results of arthroscopic subacromial decompression in impingement syndrome. METHODS: Forty-nine shoulder joints in 47 patients receiving arthroscopic subacromial decompression were prospectively followed for a mean 3...

OBJECTIVE: To investigate the method and effectiveness of coracoplasty with mini-incision for subcoracoid impingement syndrome. METHODS: Between May 2006 and September 2011, 4 patients with subcoracoid impingement syndrome were treated, including 3 cases of congenital dysplasia of the coracoid process and 1 case of anterior glenohumeral instability. There were 3 males and 1 female with an average age of 36 years (range, 20-56 years). The disease duration was 6-22 months (mean, 11...

Proximal humerus fractures (PHF) are osteoporotic fractures that affect women over 70 years of age. Like fractures of the femoral neck they have become a public health concern. As the population ages there is an increase in the number of people in poor general condition with an increased risk of falls on fragile bones. The incidence of these fractures has increased by 15% per year. All patients managed for PHF in our center in the past year were included in this prospective study (prospective cohort study; level 2)...

Seventeen athletes presenting with unexplained shoulder pain on throwing underwent arthroscopic examination. All but one practiced a throwing sport. The dominant arm was involved in all patients except one bodybuilder. Their mean age was 25 years (range 15 to 30 years), and they had symptoms present for a mean of 27 months. None had clinical, radiologic, or arthroscopic evidence of anterior instability. Preoperative clinical examination typically revealed localized pain on full external rotation and 90° abduction, signs of rupture of the rotator cuff, and positive impingement sign...