tendonosis

Injection of steroid and anesthetic into the greater trochanteric bursa is commonly performed for trochanteric bursitis, gluteus medius/minimus tendinopathy, or as a part of a barbotage procedure for gluteus medius or minimus calcific tendonosis. Trochanteric bursal injection is widely performed both with and without image guidance, and is typically viewed as low-difficulty; however optimum needle tip position can be challenging. We discuss a simple dynamic technique to aid the practitioner in optimal needle placement...

BACKGROUND: Magnetic resonance imaging (MRI) is the gold standard in diagnosing rotator cuff pathology; however, there is a lack of studies investigating the reliability agreement for supraspinatus partial-thickness tears among orthopaedic surgeons and musculoskeletal (MSK) radiologists. METHODS: Sixty digital MRI scans (1.5 Tesla) were reviewed by two orthopaedic shoulder surgeons, two MSK radiologists, two fellowship-trained shoulder surgeons, and two fellowship-trained orthopaedic surgeons at two distinct times...

Tendonosis is characterized by an increase in collagen type III relative to collagen type I, but the precise ratio of collagen type I to collagen type III in pathologic shoulder tendons has not been reported. A tendon continuously bathed in an OA synovial environment may exhibit histomorphologic differences as compared to those from shoulders with a preserved articular surface. The purpose of this study was to evaluate the biochemical and histological differences in the proximal portion of the long head of the biceps tendon (LHBT) from a non-arthritic versus an arthritic glenohumeral joint...

Posterior tibial tendon dysfunction (PTTD) is a common degenerative condition leading to a severe impairment of gait. There is currently no effective method to determine whether a patient with advanced PTTD would benefit from several months of bracing and physical therapy or ultimately require surgery. Tendon degeneration is closely associated with irreversible degradation of its collagen structure, leading to changes to its mechanical properties. If these properties could be monitored in vivo, they could be used to quantify the severity of tendonosis and help determine the appropriate treatment...

BACKGROUND: Partial thickness supraspinatus tears and tendonosis can be managed either nonoperatively or by various arthroscopic techniques. New biologic treatment approaches are currently being investigated. MRI is commonly used for objective imaging outcome evaluation but there is a lack of reliability studies. We propose a novel MRI classification of partial supraspinatus tears and tendonosis and evaluate its inter-observer and intra-observer reliability. METHODS: Digital MRI scans (3 Tesla) of 65 patients investigated for assessment of supraspinatus pathology or subacromial impingement were evaluated by three independent and experienced musculoskeletal (MSK) radiologists...

The Grand Rapids Arch Collapse classifications create a novel system for categorizing and correlating numerous common foot and ankle conditions related to a falling arch. The algorithm for treating these conditions is exceptionally replicable and has excellent outcomes. Gastrocnemius equinus diagnosis plays a crucial role in the pathology of arch collapse. A contracture of the gastrocnemius muscle is increasingly recognized as the cause of several foot and ankle conditions. The authors have expanded their indications for gastrocnemius recession to include arch pain without radiographic abnormality, calcaneus apophysitis, plantar fasciitis/fibromas, Achilles tendonosis, early-onset diabetic Charcot arthropathy, and neuropathic forefoot ulcers...

BACKGROUND: The analgesic effect of xylocaine alone versus xylocaine with corticosteroid injection after ultrasonographically (US)-guided treatment of rotator cuff calcific tendonosis has not been described in English literature. The aim of this study was to compare the analgesic effect of xylocaine only with xylocaine and corticosteroid following US-guided percutaneous treatment of rotator cuff calcific tendonosis. METHODS: This prospective study enrolled 88 patients who were given different analgesic treatments [xylocaine only, n = 23; xylocaine with corticosteroid, n = 44; control (no xylocaine or corticosteroid), n = 21]...

Extraspinal causes of radicular pain are rare and are in danger of being overlooked. Here, we present a patient with pain radiating into the posterior thigh and lateral calf. Although initial differential diagnosis included lumbar herniated nucleus pulposus, further imaging revealed the presence of gluteus maximus calcific tendonosis. After physical therapy and a potent oral steroid regimen, the pain gradually resolved and the patient was able to return to full activity.

This article is centred around the similarities and highlights some differences between a sports injury compared with any other injury profile. The authors use a musculoskeletal assessment, diagnosis and management of an injury based on a particular case study. The intention is to highlight how problems may be masqueraded in the history and perception of the injured athlete and how this perception may have complicated the injury and the rehabilitation process. This issue generates a renewed awareness for all primary care nurses and health practitioners who may be involved in treatment pathways for associated injuries related to sports medicine problems...

Calcific tendinosis (tendonosis/tendonitis) is a condition which results from the deposition of calcium hydroxyapatite crystals in any tendon of the body. Calcific tendonitis usually presents with pain, which can be exacerbated by prolonged use of the affected tendon. We report a case of calcific tendinosis in the posterior tibialis tendon at the navicular insertion. The pathology is rare in the foot, and extremely rare in the tibialis posterior tendon, indeed there are only 2 reported in the published literature...

We present plain x-ray examination, bone scintigraphy, computed tomography, and magnetic resonance imaging of 2 patients diagnosed with prostate cancer who complained of hip pain. Bone scintigraphy was suggestive for metastases. Further radiologic investigation revealed benign etiologies for the hip pain; calcific tendinitis of the vastus lateralis and tendonosis of the gluteus medius tendon were visualized.

A technique similar to the one described by Hansen for reconstruction of chronic Achilles tendinosis using the flexor hallucis longus (FHL) tendon was used in 26 patients (29 tendons). Follow-up on all 26 patients (mean age 51.3 years) is provided with an average follow-up 35 months (range, 12 to 58 months). All patients were evaluated postoperatively to assess pain, function, and alignment of the ankle and hindfoot. The AOFAS Foot Ratios for the ankle and hindfoot (total of 100 points) was used. Time to maximum improvement was 8...

Hindfoot pain from tendon pathology is common and seen in a wide range of patients from young athletes to older sedentary individuals. Magnetic resonance (MR) is an excellent technique for imaging tendons and for identifying injuries that can be treated with surgery. MR also demonstrates the presence of bone marrow edema, which is a cause of pain and often a marker for adjacent tendon injury. Finally, MR can reveal other etiologies that cause similar hindfoot pain, such as osteochondral injuries and impingement...

PURPOSE: Blood is a rich source of growth factors that can stimulate fibrocyte migration and help induce neovascular ingrowth. These properties may be able to stimulate a healing response in chronic degeneration of a tendon (tendonosis). The purpose of this study was to assess the biomechanical and histological effects of autologous blood injection on animal tendons. METHODS: New Zealand white rabbit left side patellar tendons were injected with 0.15 cc of autologous blood...

One of the difficulties with rotator cuff imaging lies in the normal variability of the tendon's signal. There may be intermediate signal present within the tendon because of magic-angle phenomenon, muscle and tendon fiber interdigitation, or tendinopathy related to degenerative changes or overuse injury. Partial and complete rotator cuff tears should be distinguishable from these causes of intermediate signal if water signal is reliably identified. This article reviews the important issue of distinguishing between rotator cuff tear and other causes of high signal in the rotator cuff, including artifacts and tendonosis...

NMR imaging has become an important diagnostic tool in the evaluation of musculoskeletal disease. However, its ability to evaluate pathogenic mechanisms of disease may eventually have even a greater impact on patient care. NMR imaging has significantly affected our understanding of the clinical significance of meniscal tears and appropriate patient management. It has also extended our understanding of the prevalence and importance of x-ray and arthroscopically occult bone, tendon and ligament injuries. By knowing the pathogenic mechanisms of disease, we can more reliably diagnose and treat pathology...

The evolution of operations to repair or substitute the anterior cruciate ligament is summarized for the period 1903 to the present. The increase in the understanding of the function of the ligament is described and in the light of this experience a programme for the management of these lesions is suggested. In acute lesions in a young sportsman the loss of the stability provided by the central pivot prevents competition at high level and operation to repair, substitute, or reinforce the ligament is recommended...

A case was reported at this private Chiropractic Office of a 50 year old white female with acute pain in the right anterior shoulder. Physical, neurological, and roentgenologic examinations revealed a diagnosis of calcific tendonosis of the right rotator cuff muscles with resultant Sub-Deltoid bursitis. A conservative regimen of therapy was instituted which included immobilization, physical therapy, manipulation, and eventually rehabilitative exercises.

A patient with the classic signs and symptoms of temporal tendonitis was treated with excisional surgery of the temporal tendon and its respective mandibular coronoid process. The excised tissue was submitted to pathology for microscopic analysis, and the results were confirmed by two pathologists. Degenerative signs of focal atrophy and tissue necrosis were evident and served to describe the focal nature of the painful condition of temporal tendonitis. The description for the pain pattern is given, along with the recommended method for diagnostic testing...