Arthroscintigraphy in Suspected Rotator Cuff Rupture

1998 ◽  
Vol 37 (08) ◽  
pp. 272-278 ◽  
Author(s):  
S. Gratz ◽  
G. Köster ◽  
T. Behr ◽  
R. Vosshenrich ◽  
E. Grabbe ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Shoulder Joint ◽  
Clinical Signs ◽  
Diagnostic Efficiency ◽  
Rotator Cuff Rupture ◽  
Lower Viscosity ◽  
Rotator Cuff Lesion ◽  
Shoulder Region ◽  
Degenerative Alterations ◽  
Additional Value

Summary Aim: In order to evaluate the diagnostic efficiency of arthroscintigraphy in suspected rotator cuff ruptures this new imaging procedure was performed 20 times in 17 patients with clinical signs of a rotator cuff lesion. The scintigraphic results were compared with sonography (n = 20), contrast arthrography (n = 20) and arthroscopy (n = 10) of the shoulder joint. Methods: After performing a standard bone scintigraphy with intravenous application of 300 MBq 99m-Tc-methylene diphosphonate (MDP) for landmarking of the shoulder region arthroscintigraphy was performed after an intraarticular injection of 99m-Tc microcolloid (ALBURES 400 μCi/5 ml). The application was performed either in direct combination with contrast arthrography (n = 10) or ultrasound conducted mixed with a local anesthetic (n = 10). Findings at arthroscopical surgery (n = 10) were used as the gold standard. Results: In case of complete rotator cuff rupture (n = 5), arthroscintigraphy and radiographic arthrography were identical in 5/5. In one patient with advanced degenerative alterations of the shoulder joint radiographic arthrography incorrectly showed a complete rupture which was not seen by arthroscintigraphy and endoscopy. In 3 patients with incomplete rupture, 2/3 results were consistant. A difference was seen in one patient with a rotator cuff, that has been already revised in the past and that suffered of capsulitis and calcification. Conclusion: Arthroscintigraphy is a sensitive technique for detection of rotator cuff ruptures. Because of the lower viscosity of the active compound, small ruptures can be easily detected, offering additional value over radiographic arthrography and ultrasound, especially for evaluation of incomplete cuff ruptures.

scholarly journals Repair of Lafosse I subscapularis injury adds no additional value in anterosuperior rotator cuff injury

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Binghao Zhao ◽  
Qingsong Zhang ◽  
Bo Liu
Keyword(s):  
Rotator Cuff ◽  
Range Of Motion ◽  
Shoulder Joint ◽  
Statistical Difference ◽  
Supraspinatus Tendon ◽  
Joint Function ◽  
Tendon Tear ◽  
Rotator Cuff Injury ◽  
Additional Value ◽  
Repair Group

Abstract Background The study aimed to explore the additional value of repair of Lafosse I subscapularis injury compared with debridement in anterosuperior rotator cuff injury. Methods The prospective study was conducted on a total of 41 patients with supraspinatus tendon tear combined with Lafosse I subscapularis injury. Eighteen patients were divided into the repair group and 23 patients were divided into the non-repair group. The two groups were compared for intraoperative parameters, pain score, range of motion of the shoulder joint, shoulder joint function and quality of life (QoL) at pre-operation, 3 and 6 months postoperatively and the final follow-up visit. Results The width of supraspinatus tendon tear did not exceed 3 cm and did not retract beyond the glenoid in among patients. There was no statistical difference of preoperative data between two groups, including age, course of disease, positive Jobe test, positive Bear-hug test, positive Lift-off test, Patte stage, longitudinal tear and pain severity (P > 0.05). Compared to preoperative levels, the severity of pain, ASES scores and EQ-5D-3L scores were significantly lower at 3 and 6 months postoperatively and the final position (P < 0.05). However, there was no statistical difference in pain severity, ASES scores and EQ-5D-3L scores between repair group and non-repair group (P > 0.05). Similarly, compared to preoperative levels, the range of motion of shoulder joint was significantly improved after operation, including internal rotation, external rotation, forward flexion and elevation (P < 0.05). However, there was no statistical difference in range of motion of shoulder joint between repair group and non-repair group (P > 0.05). Conclusion Operative treatment can effectively lessen severity of pain in the patients, improve shoulder joint function, increase the range of motion of the shoulder joint and enhance the QoL in treating anterosuperior rotator cuff injury. However, repair of subscapularis brings no benefit compared to debridement in treating supraspinatus tendon tear combined with Lafosse I subscapularis injury.

Surgical Exposures

2018 ◽  
pp. 57-70
Author(s):  
Joaquin Sanchez-Sotelo
Keyword(s):  
At Risk ◽  
Rotator Cuff ◽  
Surgical Procedures ◽  
Shoulder Joint ◽  
Shoulder Function ◽  
Front Side ◽  
Shoulder Region ◽  
Neurovascular Structures ◽  
Large Muscle

Adequate exposure is critical for any of the open surgical procedures described in this book. Although exposures may need to be modified, most of the time the same approaches are used for various procedures. Small variations on exposures also exist that are based on surgeons’ preferences. All shoulder exposures are somewhat complicated by three particular issues related to the anatomy of the shoulder region. First, the deltoid is a large muscle that wraps around the front, side, and back of the shoulder. Second, the rotator cuff, so important for shoulder function, oftentimes needs to be divided and repaired. Finally, a number of neurovascular structures are very close to the shoulder joint and at risk for injury.

scholarly journals New approaches to the use of therapeutic gymnastics and pelotherapy in the rehabilitation of patients after arthroscopic shoulder joint operations

2019 ◽  
Vol 21 (4) ◽  
pp. 70-74
Author(s):  
A V Mikhaleva ◽  
A G Kulikov ◽  
I N Makarova
Keyword(s):  
Surgical Treatment ◽  
Rotator Cuff ◽  
Thin Layer ◽  
Shoulder Joint ◽  
Clinical Symptoms ◽  
Muscle Tension ◽  
Basic Therapy ◽  
Rotator Cuff Rupture ◽  
New Approaches ◽  
Regeneration Processes

To increase the effectiveness of the rehabilitation of patients after surgical treatment of a rotator cuff rupture, 98 patients were examined and treated. It was revealed that the inclusion of exercises with dynamic controlled muscle tension in combination with thin layer pelotherapy in the medical complex, has an impact on the main clinical symptoms of the disease, regeneration processes, and contributes to an earlier restoration of the impaired functions of the shoulder joint, which is more significant than basic therapy.

Sleep Impairment

2009 ◽  
Vol 14 (3) ◽  
pp. 7-10
Author(s):  
Craig Uejo ◽  
Stephen Demeter
Keyword(s):  
Rotator Cuff ◽  
Distal Clavicle ◽  
Rotator Cuff Disease ◽  
Degenerative Arthritis ◽  
Sixth Edition ◽  
Cuff Tear ◽  
Shoulder Region ◽  
Illness Causation ◽  
Traumatic Rotator Cuff Tear ◽  
Distal Clavicle Resection

Abstract In the AMAGuides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, distal clavicle resection (resection arthroplasty of the acromioclavicular joint [ACJ]) results in ratable impairment, but only a single diagnosis within a region may be rated. Therefore, if another impairing condition is present in the shoulder region (eg, impingement syndrome or rotator cuff disease) only that resulting in the greatest causally related impairment is rated. In the setting of an occupational or other compensable injury or illness, causation of the impairment often is a key issue because, typically, only impairment that is causally related to the injury can be rated. For example, assume that a lifting injury at work caused a tear in a rotator cuff tendon that was already attenuated by repetitive impingement on inferiorly projecting spurs from longstanding degenerative arthritis of the ACJ. If surgery was performed for a traumatic rotator cuff tear and the distal clavicle also was resected due to preexisting ACJ arthritis, the latter surgery is not considered to be related to the injury. In other words, because the ACJ arthritis was neither caused nor worsened by the injury, this condition is not rated. The distal clavicular resection may have been warranted to diminish pain due to ACJ arthritis and/or eliminate the distal clavicle as a source of impingement.

scholarly journals The Relationship between Clinical Tests, Ultrasound Findings and Selected Field-Based Wheelchair Skills Tests in a Cohort of Quadriplegic Wheelchair Rugby Athletes: A Pilot Study

2021 ◽  
Vol 11 (9) ◽  
pp. 4162
Author(s):  
Lucrezia Tognolo ◽  
Alfredo Musumeci ◽  
Andrea Pignataro ◽  
Nicola Petrone ◽  
Michael Benazzato ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Shoulder Joint ◽  
Rating Scale ◽  
Clinical Tests ◽  
Wheelchair Rugby ◽  
Manual Wheelchair ◽  
Shoulder Pathology ◽  
Cord Injury ◽  
Pathologic Findings ◽  
The Relationship

Manual wheelchair use may determine shoulder joint overload and rotator cuff injury. Chronic shoulder pathologies can also influence the propulsion ability of wheelchair athletes with spinal cord injury (SCI) during sport activities. However, the relationship between shoulder pathology and wheelchair performances has never been explored. Therefore, the study aimed to investigate the correlation between shoulder pathologic findings with clinical tests and ultrasonography evaluation and the results of wheelchair performance tests. Nineteen quadriplegic wheelchair rugby players were evaluated to investigate the association between clinical and ultrasound shoulder pathologic findings and their correlation with the performance of field-based selected wheelchair skills tests (WSTs). The outcome measures were the International Wheelchair Rugby Classification Score, dominant and non-dominant Physical Examination Shoulder Score, and dominant and non-dominant Ultrasound Shoulder Pathology Rating Scale (USPRS). The WST was measured at the beginning and at one-year follow-up. A statistically significant correlation was found between the time since SCI and dominant USPRS (p < 0.005). The non-dominant USPRS was strongly related to WST at the beginning (p < 0.005) and the end of the study (p < 0.05). Data suggest that the severity of the non-dominant shoulder pathology detected on the ultrasound is related to lower performance on the WST. Chronic manual wheelchair use could be responsible for dominant SCI shoulder joint and rotator cuff muscle damage, while non-dominant USPRS could be related to performance on the WST.

scholarly journals Is it the coracobrachialis superior muscle, or is it an unidentified rare variant of coracobrachialis muscle?

2021 ◽  
Author(s):  
Łukasz Olewnik ◽  
Nicol Zielinska ◽  
Łukasz Gołek ◽  
Paloma Aragonés ◽  
Jose Ramon Sanudo
Keyword(s):  
Case Report ◽  
Rare Variant ◽  
Shoulder Joint ◽  
Biceps Brachii ◽  
Coracoid Process ◽  
Biceps Brachii Muscle ◽  
Shoulder Region

AbstractThe coracobrachialis muscle (CBM) originates from the apex of the coracoid process, in common with the short head of the biceps brachii muscle, and from the intermuscular septum. The CBM demonstrates variability in both the proximal and distal attachment, with some extremely rare varieties, such as the coracobrachialis superior, coracobrachialis longus and coracocapsularis muscle. This case report describes an extremely rare variant of the coracobrachialis superior muscle, or a very rare variant of the CBM. Our findings highlight the importance of muscle variants in the shoulder region, especially the coracoid region, and are significant for radiologists, anatomists, physiotherapists and surgeons specializing in the shoulder joint.

Lesions of the Biceps Tendon Diagnosis and Classification

1999 ◽  
Vol 12 (04) ◽  
pp. 188-195 ◽  
Author(s):  
J. F. Bardet
Keyword(s):  
Shoulder Joint ◽  
Biceps Brachii ◽  
Shoulder Arthroscopy ◽  
Case Reports ◽  
Biceps Tendon ◽  
Adhesive Capsulitis ◽  
Clinical Signs ◽  
Joint Disease ◽  
Response To Treatment ◽  
Biceps Tendon Rupture

SummaryThis paper presents the clinical signs, radiographic and arthroscopic findings in 23 dogs and a cat having a lesion of the biceps tendon. Several conditions were recognized: partial or complete rupture; avulsion of the biceps tendon from the supraglenoid tubercle, tendinitis, mid-substance tear, bipartite tendon, dislocations and tenosynovitis of the bicipital tendon. Osteoarthritis of the shoulder joint was seen in 84% of the cases and osteophytosis of the bicipital groove was recognized in 38%. Biceps tendon rupture was associated with shoulder joint instability 76% of the time. Shoulder arthroscopy is a very reliable diagnostic method allowing direct visualization of intra-articular pathologies.In man, the tendon of the biceps brachii is the proverbial stepchild of the shoulder. It has been blamed for numerous painful conditions of the shoulder from arthritis to adhesive capsulitis. Kessell described the tendon as “somewhat of a maverick, easy to inculpate but difficult to condemn (1). Its function has been often misunderstood. It has been tenodesed, translocated, pulled through drill holes in the humeral head, and debrided with an arthroscope, oftentimes with marginal results”. Lippmann likened the biceps tendon to the appendix: “An unimportant vestigial structure unless something goes wrong with it” (2). Neer II has stressed the fact that 95 to 98 per cent of patients with a diagnosis of biceps tendinitis have, in reality, a primary diagnosis of impingement syndrome with secondary involvement of the biceps tendon (3). He has condemned routine biceps tenodesis.The veterinary literature on the biceps tendon in dogs is sparse (4-8). Tenosynovitis of the biceps tendon is “a common cause of forelimb lameness in medium and large breed dogs” (7). “Definitive diagnosis of bicipital tenosynovitis is often not possible, and the diagnosis is backed into by eliminating other causes of lameness. Proof of the diagnosis often depends on response to treatment” (7). There are not any reviews of cases of rupture of the tendon of the biceps brachii muscle except for anecdotal case reports (7). Arthrography has been described as diagnostic of rupture (10, 11). Calcifying tendinopathy of the biceps tendon was seen on radiographic views of the scapulohumeral joint in four dogs (9). Twodimensional real-time ultrasonography was found helpful in the diagnosis of strain of the infraspinatus muscle in a dog (12).This paper reviews the pertinent anatomy, explains the function of the biceps tendon, and presents a review of current concepts on the diagnosis of lesions of the biceps tendon.The author presents the clinical signs, radiographic and arthroscopic finding of the disorders of the biceps tendon seen in 25 shoulders. All biceps tendon lesions may be classified in one of the six subtypes. Partial or complete tears are the most frequent pathology. Degenerative joint disease is seen in 84% of the shoulders.

scholarly journals Biceps Detachment Preserves Joint Function in a Chronic Massive Rotator Cuff Tear Rat Model

2018 ◽  
Vol 46 (14) ◽  
pp. 3486-3494 ◽  
Author(s):  
Mengcun Chen ◽  
Snehal S. Shetye ◽  
Julianne Huegel ◽  
Corinne N. Riggin ◽  
Daniel J. Gittings ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Shoulder Joint ◽  
Shoulder Function ◽  
Rotator Cuff Tears ◽  
Subscapularis Tendon ◽  
Joint Function ◽  
Massive Rotator Cuff Tears ◽  
Sham Surgery ◽  
Biceps Tenotomy

Background: Lesions of the long head of the biceps tendon are often associated with massive rotator cuff tears (MRCTs), and biceps tenotomy is frequently performed for pain relief and functional reservation. However, the efficacy and safety of biceps tenotomy regarding the effects on the surrounding tissues in chronic MRCT are unclear. Hypothesis: Biceps tenotomy would result in improved mechanical and histological properties of the intact subscapularis tendon and improved in vivo shoulder function while not compromising glenoid cartilage properties. Study Design: Controlled laboratory study. Methods: Right supraspinatus and infraspinatus tendons were detached in 25 male Sprague-Dawley rats, followed by 4 weeks of cage activity to create a chronic MRCT condition. Animals were randomly divided into 2 groups and received either biceps tenotomy (n = 11) or sham surgery (n = 14) and were sacrificed 4 weeks thereafter. Forelimb gait and ground-reaction forces were recorded 1 day before the tendon detachment (baseline), 1 day before the surgical intervention (biceps tenotomy or sham), and 3, 7, 10, 14, 21, and 28 days after the intervention to assess in vivo shoulder joint function. The subscapularis tendon and glenoid cartilage were randomly allocated for mechanical testing or histologic assessment after the sacrifice. Results: Compared with sham surgery, biceps tenotomy partially restored the in vivo shoulder joint function, with several gait and ground-reaction force parameters returning closer to preinjury baseline values at 4 weeks. With biceps tenotomy, mechanical properties of the subscapularis tendons were improved, while mechanical properties and histological Mankin scores of the glenoid cartilage were not diminished when compared with the sham group. Conclusion: Biceps tenotomy in the presence of chronic MRCT partially preserves overall shoulder function and potentially restores subscapularis tendon health without causing detrimental effects to joint cartilage. This laboratory study adds to the growing literature regarding the protective effects of biceps tenotomy on the shoulder joint in a chronic MRCT model. Clinical Relevance: This study provides important basic science evidence supporting the use of biceps tenotomy in patients with massive rotator cuff tears.

scholarly journals Interest of Ultrasound in the Exploration of Rotator Cuff Lesions - Confrontation of Clinical Examination and Ultrasound Finding

2018 ◽  
Vol 5 ◽  
Author(s):  
Nessrine Akasbi ◽  
Asmae El Aissaoui ◽  
Ikrame Yazghich ◽  
Samira El Fakir ◽  
Taoufik Harzy
Keyword(s):  
Rotator Cuff ◽  
Physical Examination ◽  
Clinical Examination ◽  
High Sensitivity ◽  
Diagnostic Value ◽  
Ultrasound Finding ◽  
X Ray ◽  
Rotator Cuff Lesion ◽  
Rotator Cuff Lesions ◽  
A Prospective Study

Introduction: The aim of our study was to evaluate the interest of ultrasound in the exploration of painful shoulders evoking rotator cuff lesions and to determine the diagnostic value of the different tendon tests through a confrontation physical examination versus shoulder ultrasound. Materials and methods: A prospective study was conducted including patients consulting for shoulder pain that suggests a rotator cuff lesion. All patients underwent a clinical examination, an x ray and shoulder ultrasound.Results: The confrontation physical examination versus shoulder ultrasound showed that Jobe's test is very sensitive (100%) but less specific (27%), the Patte test, has a high sensitivity (100%) but an average specificity (51%), the Palm-Up test was fairly sensitive (91%) but not very specific (43%) and the Gerber test was more specific (95.7%) and less sensitive (38%). The comparison between x ray and ultrasound showed that ultrasound of shoulder is more efficient in the detection of calcifications and erosions of humeral head.Conclusion: Ultrasound of shoulder is more performant than physical examination and x ray in exploring the rotator cuff lesions.

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