Poster 182: Nontraumatic Full-Thickness Gluteus Medius Tendon Rupture and Partial Thickness Gluteus Minimus Tendon Tear: A Case Report

PM&R ◽  
2010 ◽  
Vol 2 ◽  
pp. S83-S84
Author(s):  
Jason A. Lee ◽  
Christopher Reger
PM&R ◽  
2010 ◽  
Vol 2 ◽  
pp. S77-S77
Author(s):  
Ramya Nagarajan ◽  
Nancy M. DeSantis

2021 ◽  
pp. 1-10
Author(s):  
Heping Deng ◽  
Yaru Mi ◽  
Bo Lu ◽  
Ping Xu

OBJECTIVE: To explore the value of virtual touch imaging and quantification (VTIQ) shear wave elastography (SWE) in diagnosis of supraspinatus tendon tear. METHODS: Eighty patients with unilateral supraspinatus tendon tear underwent shoulder arthroscopy were prospective studied. Tendinopathy, partial-thickness tear or full-thickness tear of supraspinatus tendon were diagnosed according 2D ultrasound examination. Sensitivity, specificity and accuracy of ultrasonic diagnosis of supraspinatus tendon tear were calculated by arthroscopy as the gold standard. VTIQ was applied to measure the shear-wave velocity (SWV) of both normal and affected supraspinatus tendon. The differences of SWV in three types of supraspinatus tendon tear and receiver operating characteristic (ROC) curves were analyzed. RESULTS: Among 80 patients, there were 20 tendinopathy, 31 partial tears and 29 full-thickness tears diagnosed by shoulder arthroscopy. Sensitivity, specificity and accuracy of 2D ultrasound in diagnosis of tendinopathy, partial tear and full-thickness tear groups were 78%, 90%and 83%; 71%, 86%and 73%; 86%, 88%and 88%, respectively. SWV of 80 supraspinatus tendon tears was 4.59±1.00 m/s, which was lower than that of normal supraspinatus tendon (4.59±1.00 m/s vs. 6.68±1.05 m/s, P <  0.01). SWV of supraspinatus tendon in tendinopathy, partial tear and full-thickness tear groups respectively were 5.66±0.97, 4.66±1.00, and 3.78±0.55 m/s, all lower than that of the contralateral normal supraspinatus tendon (all P <  0.05). In addition, the analysis of variance and pairwise comparison showed that SWV of supraspinatus tendon among three different degree of injury was statistically significant (all P <  0.001). The cutoff thresholds of SWV was 4.83 m/s to identify tendinopathy tear from partial tear and was 4.08 m/s to identify full-thickness tear from partial-thickness tear. CONCLUSION: VTIQ SWE with SWV might identify degree of supraspinatus tendon tear and improve the value of ultrasonography, which should be further evaluated in large multicenter studies.


2020 ◽  
Vol 48 (12) ◽  
pp. 2933-2938
Author(s):  
Mitchell B. Meghpara ◽  
Rishika Bheem ◽  
Sapan Shah ◽  
Jacob Shapira ◽  
David R. Maldonado ◽  
...  

Background: There is a paucity of literature on asymptomatic gluteus medius pathology. Moreover, no studies have examined the prevalence of asymptomatic gluteus medius pathology. Purpose: To describe the prevalence of asymptomatic gluteus medius pathology in patients undergoing hip arthroscopy for femoroacetabular impingement. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A database search of our institution was performed for patients undergoing hip arthroscopy for labral treatment between February 2008 and January 2019. Patients were included if they had gluteus medius pathology identified through magnetic resonance imaging (MRI). Patients were deemed to be asymptomatic if they lacked greater trochanteric hip tenderness, abductor weakness, a positive Trendelenburg sign, or a positive Trendelenburg gait on physical examination. Patients were excluded if they were unwilling to participate or did not have a documented physical examination or MRI read in the database. Results: A total of 2851 hips (2452 patients) met the inclusion/exclusion criteria. Gluteus medius pathology was found in 871 hips (30.6%) on MRI. Symptomatic gluteus medius pathology was observed in 414 (14.5%) hips, of which 305 (10.7%) had tendinosis, 99 (3.5%) had partial-thickness tears, and 10 (0.4%) had full-thickness tears. Asymptomatic gluteus medius pathology was observed in 457 (16.0%) hips, of which 408 (14.3%) had tendinosis and 49 (1.7%) had partial-thickness tears. No hips with full-thickness tears on MRI were asymptomatic. Patients with asymptomatic partial-thickness tears were significantly older than those with only tendinosis (45.3 vs 39.4 years, respectively; P = .001). Patients aged 40 years or older had a 2.11 (1.80-2.50) ( P < .001) relative risk of asymptomatic pathology compared with patients younger than 40 years. Conclusion: Although there is a meaningful prevalence of asymptomatic gluteus medius tendinosis, the prevalence of asymptomatic gluteus medius tears is low. Treatment of gluteus medius tendinosis should therefore be based not solely on MRI findings but rather on a complete clinical evaluation. In contrast, MRI findings of partial or full-thickness gluteus medius tears may be more likely to have clinical significance.


Author(s):  
Ramanan Rajakulasingam ◽  
Christine Azzopardi ◽  
Peter Dutton ◽  
David Beale ◽  
Rajesh Botchu

AbstractIliopsoas tendon tears are rare. These typically occur in young and can be associated with avulsion fractures of lesser trochanter. We report a case of full thickness rupture of iliopsoas tendon in 87-year-old male without avulsion of the lesser trochanter.


JPRAS Open ◽  
2021 ◽  
Author(s):  
Seigo Suganuma ◽  
Kaoru Tada ◽  
Shingo Takagawa ◽  
Hidetoshi Yasutake ◽  
Keito Shimanuki ◽  
...  

Author(s):  
Aniket Agarwal ◽  
Kavita Vani ◽  
Anurag Batta ◽  
Kavita Verma ◽  
Shishir Chumber

Abstract Background Objectives: To comparatively evaluate the role of ultrasound and MRI in rotator cuff and biceps tendon pathologies and to establish ultrasound as a consistently reproducible, quick and accurate primary investigation modality sufficient to triage patients requiring surgical correction of full thickness rotator cuff tears. Methods: Fifty patients, clinically suspected to have rotator cuff and/or biceps tendon pathologies, with no contraindications to MRI, were evaluated by US and MRI, in a prospective cross-sectional observational study. US was done with high-frequency linear probe, and MRI was done on a 1.5-T scanner using T1 oblique sagittal, proton density (PD)/T2 fat-suppressed (FS) oblique sagittal, T1 axial, PD/T2 FS axial, T1 oblique coronal, T2 oblique coronal and PD FS oblique coronal sequences. Statistical testing was conducted with the statistical package for the social science system version SPSS 17.0. The sensitivity, specificity, PPV, NPV and accuracy were also calculated to analyze the diagnostic accuracy of US findings correlating with MRI findings. A p value less than 0.05 was taken to indicate a significant difference. Results Mean age was 45 years; 74% patients were males; 77% females and 60% males had tears. Majority of patients with rotator cuff tears were in the sixth decade of life. The frequency of tears was higher among older patients. Fourteen percent of patients had full thickness tears while 64% had partial thickness tears. US was comparable to MRI for detection of full thickness tears with overall sensitivity, specificity, PPV and accuracy of 93.8%, 100%, 100% and 98.2%, respectively (p value < 0.001). For partial thickness tears, US had overall sensitivity, specificity, PPV and accuracy of 75.6%, 82.6%, 89.5% and 78%, respectively (p value < 0.001), as compared to MRI. Subacromial-subdeltoid bursal effusion and long head of biceps tendon sheath effusion were common associated, though, non-specific findings. Conclusion Ultrasound findings in our study were found to be in significant correlation with findings on MRI in detection of rotator cuff tears. US was equivalent to MRI in detection of full thickness tears and fairly accurate for partial thickness tears. Therefore, US should be considered as the first line of investigation for rotator cuff pathologies.


2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S130-S131
Author(s):  
Andrew Khalifa ◽  
Anzar Sarfraz ◽  
Jacob B Avraham ◽  
Ronnie Archie ◽  
Matthew Kaminsky ◽  
...  

Abstract Introduction Electrical injuries represent 0.4–3.2% of admissions to burn units and are responsible for &gt;500 deaths per year in the United States. Approximately half occur in the workplace and are the fourth leading cause of work-related-traumatic death. The extent of injury can be drastically underestimated by total body surface area percentage (TBSA). Along with cutaneous burns, high voltage electrical injuries can lead to necrosis of muscle, bone, nervous tissue, and blood vessels. Aggressive management allows for patient survival, but at significant cost. Newer technologic advances help improve functional outcomes. Methods This case-report was conducted via retrospective chart review of the case presented. Results A 43-year-old male sustained a HVEI (&gt;10, 000 V) after contacting an active wire while working as a linesman for an electric company. He presented after less than 15-minute transport from an outside hospital with full thickness burns and auto-amputation to all fingers on both hands and the distal third of the left hand (Images 1 and 2). There were full thickness circumferential burns to the entire left and right upper extremities with contractures, with the burns extending into the axilla, and chest wall musculature. The patient had 4th degree burns and a large wound to the left shoulder with posterior extension to the scapula, flank and back with approximately 25% TBSA (Image 3). Compartments were tense in both upper extremities. Patient was sedated and intubated to protect the airway and placed on mechanical ventilation. A femoral central line was then placed, and the patient was given pain control, continued fluid resuscitation, and blood products. Dark red colored urine from a foley catheter that was immediately identified as rhabdomyolysis induced myoglobinuria. Labs drawn demonstrated elevated troponin I, CK &gt;40,000. BUN 18, creatinine 1.0, K+ 5.2 and phosphate 5.6. Decision was made immediately for operative intervention with emergent amputation of both upper extremities in the light of rhabdomyolysis secondary to tissue necrosis and oliguria. During the patient’s hospital course, he underwent multiple operations for further debridement with vacuum-assisted closure therapy and skin grafting of sites, as well as targeted muscle reinnervation (TMR) 6 months later at an outside hospital. Conclusions Although HVEI only account for a small percentage of burn admissions, they are associated with greater morbidity than low-voltage injuries. Patients with HVEI often incur multiple injuries, more surgical procedures, have higher rates of complications, and more long term psychological and rehabilitative difficulties. Despite the need for amputation in some of these critically ill patients, options exist that allow for them to obtain long term functional success.


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