Practicability of a Virtual Consultation to Evaluate the Shoulder Joint

2021 ◽  
Author(s):  
Martin Gathen ◽  
Davide Cucchi ◽  
Tom Jansen ◽  
Hans Goost ◽  
Frank Alexander Schildberg ◽  
...  
Keyword(s):  
Physical Examination ◽  
Shoulder Joint ◽  
Trauma Surgery ◽  
Provocation Test ◽  
Resource Conservation ◽  
Stability Criteria ◽  
Mobility Function ◽  
Video Consultation ◽  
Shoulder Disorders ◽  
Long Head

Abstract Objective In the course of the corona pandemic, resource conservation and the protection of further infections have made it necessary to break new ground in the organisation of orthopaedic and trauma surgery consultations. One solution is consistent digitisation and the offer of video consultation hours. In this study, non-contact examination of patients with shoulder disorders is described and critically examined. Methods Thirty patients who presented with pathologies of the shoulder joint in a university outpatient clinic were subjected to a physical examination in a conventional and contactless manner. The data obtained on mobility, function and provocation test of both examinations were compared to draw conclusions about the virtual feasibility. Results 46% of the patients suffered from a traumatic shoulder lesion, and 54% showed degenerative lesions. The assessment of mobility showed a high correlation of 70 – 90% between the two examinations. Common tests to evaluate the supraspinatus, infraspinatus, subscapularis and the long head of the biceps could be adequately performed in a contactless version by more than three quarters of the patients, but with low-to-moderate performance values. Conclusion Contact-less examination is particularly disadvantageous when evaluating stability criteria. For the medical history and functional test, there were no significant differences between the classic consultation and contactless consultation. Although virtual consultation is a widespread and valuable addition in pandemic times, it cannot replace a safe assessment and indication by personal examination.

scholarly journals A practical, evidence-based, comprehensive (PEC) physical examination for diagnosing pathology of the long head of the biceps

2017 ◽  
Vol 26 (8) ◽  
pp. 1484-1492 ◽  
Author(s):  
Samuel Rosas ◽  
Michael K. Krill ◽  
Kelms Amoo-Achampong ◽  
KiHyun Kwon ◽  
Benedict U. Nwachukwu ◽  
...  
Keyword(s):  
Physical Examination ◽  
Evidence Based ◽  
Long Head

scholarly journals What Is the Diagnosis in Patients with Type 2 Diabetes Who Have a Painful Shoulder? Results from a Prospective Cross-Sectional Study

2020 ◽  
Vol 9 (12) ◽  
pp. 4097
Author(s):  
Login Alabdali ◽  
Jasmien Jaeken ◽  
Nens van Alfen ◽  
Geert-Jan Dinant ◽  
Rob Borghans ◽  
...  
Keyword(s):  
Physical Examination ◽  
Shoulder Pain ◽  
Ultrasound Imaging ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Painful Shoulder ◽  
Patients With Diabetes ◽  
Shoulder Disorders

Background: Patients with diabetes mellitus have higher risk of developing shoulder pathology. However, only adhesive capsulitis is addressed in shoulder pain guidelines as a disorder associated with diabetes. Yet, patients with diabetes are at risk of having several other shoulder disorders, including focal neuropathy. Our aim was to quantify the presence of shoulder disorders using physical examination and ultrasound imaging in patients with type 2 diabetes (T2DM) suffering from shoulder pain in general practice. Methods: In this prospective cross-sectional study, patients with T2DM who had had a painful shoulder for at least four weeks were included. Patients filled out a questionnaire and underwent a physical examination of the shoulders and feet and ultrasound imaging of the shoulder. Results: A total of 66 patients were included, of whom 40.9% (n = 27) had bilateral complaints resulting in 93 symptomatic shoulders. Subacromial pain syndrome was most frequently diagnosed by physical examination (66.6%, 95% CI 51.6–72.0%; p < 0.0001), while ultrasound imaging showed that subacromial disorders were statistically significantly the most prevalent (90.3%, 95% CI 81.9–95.2%). Only two patients (3%) were diagnosed with neuropathic shoulder pain. Conclusion: When choosing treatment, general practitioners should be aware that in patients with T2DM the subacromial region is most frequently affected.

The Rocking Pelvis

2020 ◽  
pp. 67-74
Author(s):  
Hoi See Tsao ◽  
Robyn Wing
Keyword(s):  
Physical Examination ◽  
Diagnostic Tests ◽  
Treatment Options ◽  
Trauma Surgery ◽  
Pelvic Trauma ◽  
Pelvic Fractures ◽  
Concomitant Injuries ◽  
Pelvic Injuries ◽  
Retrograde Urethrogram ◽  
Rectal Injuries

This chapter reviews the pelvic and genitourinary physical examination in the setting of pelvic trauma, the types of pelvic fractures, and diagnostic tests available, including ultrasound, plain radiography, and computed tomography, to evaluate for pelvic injuries. It discusses the management principles of fluid resuscitation and hemorrhage control with an unstable pelvis, including consideration of consultation with trauma surgery, orthopedic surgery, and interventional radiology. It examines the types of concomitant injuries that may be expected, including splenic, hepatic, urethral, and rectal injuries and emphasizes the need for individualized workup and management for each patient based on a thorough physical examination. The indications for a retrograde urethrogram and treatment options for pelvic fractures are also briefly reviewed.

scholarly journals Arthroscopic Tenotomy of the Long Head of the Biceps Tendon and Section of the Anterior Joint Capsule Produce Moderate Osteoarthritic Changes in an Experimental Sheep Model

2021 ◽  
Vol 18 (14) ◽  
pp. 7471
Author(s):  
Umile Giuseppe Longo ◽  
Francisco Forriol ◽  
Vincenzo Candela ◽  
Salvatore Maria Tecce ◽  
Sergio De Salvatore ◽  
...  
Keyword(s):  
Shoulder Joint ◽  
Glenohumeral Joint ◽  
Biceps Tendon ◽  
Joint Capsule ◽  
Quantitative Mri ◽  
Degenerative Changes ◽  
Histological Evaluation ◽  
Sheep Model ◽  
Long Head ◽  
Development And Evolution

Osteoarthritis (OA) of the glenohumeral (GH) joint is a common cause of shoulder pain, resulting in considerable invalidity. Unfortunately, the study of its pathogenesis is challenging. Models of OA are necessary to identify specific targets for therapy and to be able to interfere with the development and evolution of OA. This study aims to assess the effect of an arthroscopic tenotomy of the long head of the biceps tendon (LHBT) and section of the anterior glenohumeral joint capsule on the ovine glenohumeral joint. In addition, the authors aim to validate and evaluate the reliability of a modified semi-quantitative MRI score to assess joint degeneration in a sheep’s shoulder. Eight skeletally mature sheep received an arthroscopic tenotomy of the LHBT and section of the anterior joint capsule and were euthanized four months after surgery. All animals tolerated the surgery well, and no complication was recorded for six weeks. Moderate degenerative changes to the ovine shoulder joint were found on MRI and histological evaluation. The arthroscopic tenotomy of the LHBT and the anterior glenohumeral joint capsule section caused moderate degenerative changes to the ovine shoulder joint.

PHYSICAL EXAMINATION AND DIAGNOSIS OF DEMENTIA FOR VIDEO CONSULTATION

2008 ◽  
Vol 56 (5) ◽  
pp. 947-949 ◽  
Author(s):  
Melinda Martin-Khan ◽  
Paul Varghese ◽  
Richard Wootton ◽  
Len Gray
Keyword(s):  
Physical Examination ◽  
Video Consultation ◽  
Diagnosis Of Dementia

Diagnostic accuracy of scapular physical examination tests for shoulder disorders: a systematic review

2012 ◽  
Vol 47 (14) ◽  
pp. 886-892 ◽  
Author(s):  
Alexis A Wright ◽  
Craig A Wassinger ◽  
Mason Frank ◽  
Lori A Michener ◽  
Eric J Hegedus
Keyword(s):  
Systematic Review ◽  
Physical Examination ◽  
Diagnostic Accuracy ◽  
Shoulder Disorders

Physical Examination for Partial Tears of the Biceps Tendon

2007 ◽  
Vol 35 (8) ◽  
pp. 1334-1340 ◽  
Author(s):  
Harpreet S. Gill ◽  
George El Rassi ◽  
Michael S. Bahk ◽  
Renan C. Castillo ◽  
Edward G. McFarland
Keyword(s):  
Rotator Cuff ◽  
Positive Predictive Value ◽  
Physical Examination ◽  
Predictive Value ◽  
Biceps Tendon ◽  
Likelihood Ratios ◽  
Partial Tears ◽  
Long Head ◽  
Sensitivity Specificity ◽  
Arthroscopic Procedures

Background The accuracy of the physical examination for tears of the long head of the biceps remains controversial. Purpose The goals were 1) to characterize the occurrence of partial tears of the long head of the biceps tendon in a group of consecutive patients, and 2) to analyze the diagnostic value of various clinical tests for pathologic lesions of the proximal biceps tendon. Study Design Cohort study (diagnosis); Level of evidence, 2. Methods Of 847 consecutive patients who underwent arthroscopic procedures for a variety of shoulder conditions, 40 were found at the time of arthroscopy to have partial biceps tendon tears. The average age of these 24 men and 16 women was 59 years (range, 18-83). Preoperative physical examinations had included 9 commonly used tests for shoulder examination. Statistical analysis included sensitivity, specificity, negative predictive value, positive predictive value, and likelihood ratios for these tests. Results The prevalence rate of partial tears was 5% (40/847) of all arthroscopic procedures. The most commonly associated conditions included rotator cuff tears (85% [34/40]) and anterior instability (7.5% [3/40]). Tenderness on palpation of the long head of the biceps tendon had a sensitivity of 53%, a specificity of 54%, and a likelihood ratio of 1.13. The sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratios for Speed's test were 50%, 67%, 8%, 96%, and 1.51, respectively. Conclusion In patients with rotator cuff abnormality, the diagnosis of partial biceps tears cannot be made reliably with existing physical examination tests. Diagnostic arthroscopy is recommended, if clinically indicated, for potential partial tears of the long head of the biceps tendon. The treating physician should be prepared to treat unsuspected tears of the long head of the biceps tendon at the time of surgery.

A Feasibility Pilot Study on the Use of Telemedicine for the Examination of the Knee Joint

2020 ◽  
Author(s):  
Sebastian Scheidt ◽  
Michael Kehrer ◽  
Max Jaenisch ◽  
Hans Goost ◽  
Dieter Christian Wirtz ◽  
...  
Keyword(s):  
Knee Joint ◽  
Physical Examination ◽  
National Level ◽  
Treatment Modalities ◽  
Medical Background ◽  
Leg Axis ◽  
Number Of Patients ◽  
Video Consultation ◽  
The Mean ◽  
Self Examination

Abstract Background In times of a pandemic threat, such as COVID-19, and the need for reduced direct doctor-patient contact, internet-based telemedicine has attracted more and more attention as a surrogate service. Suspending the diagnosis and treatment of non-virus related diseases for longer periods of time is not a viable option since this would only exacerbate problems on the patient and national level. The need for alternative treatment modalities increased rather quickly. So far, telemedical applications have mainly focused on teleradiological diagnosis, follow-up and monitoring of psychiatric and internal diseases, as well as geriatric patient care. As far as these authors are aware, orthopaedic physical examination of the knee joint, including trauma work-up, has not been the subject of any studies to date. This feasibility study explores how video consultation can be designed and implemented in the context of history taking and physical examination in knee joint complaints. Material and Method 21 patient actors (PA) with simulated complaints of the knee joint were examined individually for each diagnosis, first via video consultation and then directly by a specialist (SP). One PA group has a medical background, the other was made up of laypersons. The time was measured for both types of consultation. The physician documented the detected symptoms, the quality of implementation of the self-examination steps, and the derived diagnosis on an assessment form. After completion of both consultation sessions, the PAs were handed a questionnaire on the respective examination modality. Results With the video consultation the examination lasted 8.63 (± 2.5) minutes on average and with the regular consultation in person 5.63 (± 1.7) minutes (p < 0.001). For the group with medical background the examination lasted 7.67 (± 1.4) minutes on average, while for the lay group the video consultation took 9.7 (± 3.1) minutes (p = 0.049). With increased age, the video consultation was prolonged (p = 0.032; r = 0.47). The mean value for self-examination of leg axis, gait pattern and degrees of freedom was 9.32 (± 0.4) of 10 points. The following functional tests resulted in lower mean values (points): Payr 7.2 (± 2.3), Merke 5.9 (± 2.8), no-touch Lachmann 6.4 (± 2.7), gravity sign-recurvatum 6.7 (± 2.4). The mean grade by the PAs for the feasibility of self-examination was 2.43 (± 0.98) out of 5 points. Conclusion The video consultation for musculoskeletal complaints of the knee joint allows exploratory remote examination and helps to minimise the number of patients in hospitals and practices. It takes longer for the physician to perform and does not permit functional testing for ligament injuries of the knee joint. In its present form, telemedical examination is not able to fully replace personal consultation.

scholarly journals Unilateral Four-Headed Pectoralis Muscle Major

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Rasheed Bani Hammad ◽  
Adel Mohamed
Keyword(s):  
Shoulder Joint ◽  
Biceps Brachii ◽  
Pectoralis Major Muscle ◽  
Pectoralis Major ◽  
Pectoralis Muscle ◽  
Lateral Aspect ◽  
Caucasian Male ◽  
Male Cadaver ◽  
Long Head

A unilateral four-headed pectoralis major muscle was observed on the left side of an 83 year-old Caucasian male cadaver. The accessory tendon arises from the lateral aspect of the pectoralis major muscle, travels along with the tendon of the long head of the biceps brachii and blends into the capsule of the shoulder joint. This anomaly is rare. A complete or partial absence of pectoralis major muscle is normally reported. Additionally, supernumerary heads of muscles other than pectoralis major have been documented. However, the existence of an accessory tendon to the pectoralis major muscle is unique. The implications of such a finding are discussed.

scholarly journals Patient assistive system for the shoulder joint

2016 ◽  
Vol 2 (1) ◽  
pp. 731-734 ◽  
Author(s):  
Erika Scheuner ◽  
Jonas Fabech ◽  
Dominik Textor ◽  
Roman Kuster ◽  
Bernd Heinlein
Keyword(s):  
Range Of Motion ◽  
Health Professionals ◽  
Surface Electromyography ◽  
Shoulder Joint ◽  
Independent Living ◽  
Healthy Subjects ◽  
Upper Arm ◽  
Everyday Activities ◽  
Shoulder Disorders ◽  
Further Development

AbstractThe mobility of the upper extremity is essential for everyday activities and for independent living. Shoulder disorders affect the range of motion, therefore a patient assistive system (PAS) for the shoulder joint can be used to compensate the restrictions. The developed PAS supports up to 120° of flexion and abduction. The portable dynamic orthotic consists of two levers and is attached to a hip belt. The upper arm of the patient is connected to the device using a brace. The prototype is driven by one motor and controlled by surface electromyography (EMG). The functionality of the system was successfully verified by tests with healthy subjects. For further development, a study with shoulder patients will be performed and health professionals will evaluate the PAS.

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