Shoulder Arthrography

2019 ◽  
pp. 149-150
Author(s):  
Matthew DelGiudice
Keyword(s):  
Rotator Cuff ◽  
Glenohumeral Joint ◽  
Adhesive Capsulitis ◽  
Total Shoulder Arthroplasty ◽  
Mr Arthrography ◽  
Routine Clinical Practice ◽  
Ct Arthrography ◽  
Cuff Tear ◽  
Shoulder Arthrography ◽  
Cuff Repair

Chapter 98 describes indications, technique, and imaging findings of shoulder arthrography. Shoulder arthrography is commonly performed in routine clinical practice for MR arthrography (MRA), typically in younger patients. The main indications include evaluation of shoulder instability and postoperative rotator cuff. Other indications include fluoroscopic guidance for therapeutic injections or therapy for adhesive capsulitis. CT arthrography (CTA) may also be performed for evaluation of total shoulder arthroplasty (TSA) loosening and conversion from anatomic to reverse TSA. Contrast should be easy to inject and disperse throughout the joint. Abnormal communication between the glenohumeral joint and subacromial-subdeltoid and subcoracoid bursae is diagnostic of a full-thickness rotator cuff tear unless the contrast is accidentally injected into the bursa. However, in the setting of prior rotator cuff repair, contrast may extend into the bursa even in the absence of re-tear because the cuff is not watertight. Contrast extension into the glenoid labral substance is diagnostic of labral tear.

scholarly journals Previous Rotator Cuff Repair Is Associated With Inferior Clinical Outcomes After Reverse Total Shoulder Arthroplasty

2017 ◽  
Vol 5 (10) ◽  
pp. 232596711773031 ◽  
Author(s):  
Edward J.W. Shields ◽  
Denise M. Koueiter ◽  
Tristan Maerz ◽  
Adam Schwark ◽  
J. Michael Wiater
Keyword(s):  
Rotator Cuff ◽  
Shoulder Arthroplasty ◽  
Rotator Cuff Repair ◽  
Total Shoulder Arthroplasty ◽  
Shoulder Surgery ◽  
Reverse Total Shoulder Arthroplasty ◽  
Cuff Tear ◽  
Reverse Total Shoulder ◽  
Cuff Repair

Background: Although recent evidence suggests that any prior shoulder surgery may cause inferior shoulder arthroplasty outcomes, there is no consensus on whether previous rotator cuff repair (RCR) is associated with inferior outcomes after reverse total shoulder arthroplasty (RTSA). Purpose: To retrospectively compare outcomes in patients who underwent RTSA with and without previous RCR. Study Design: Cohort study; Level of evidence, 3. Methods: Patients with prior RCR and those without previous shoulder surgery (control) who underwent RTSA for cuff tear arthropathy or irreparable cuff tear were retrospectively identified from a prospective database. Exclusion criteria included revision arthroplasty, fractures, rheumatoid arthritis, dislocations, infection, prior non-RCR procedures, less than 12 months of follow-up, and latissimus dorsi tendon transfer. The American Shoulder and Elbow Surgeons (ASES) score, ASES Activities of Daily Living (ADL) score, visual analog scale (VAS) score for pain, Subjective Shoulder Value (SSV), and range of motion (ROM) were compared between groups. Results: Patients with previous RCR (n = 83 shoulders) were younger (mean ± SD, 67 ± 10 vs 72 ± 8 years; P < .001) and more likely to be male (46% vs 32%, P = .033) than controls (n = 189 shoulders). No differences were found in follow-up duration (25 ± 13 vs 26 ± 13 months, P = .734), body mass index, or any preoperative outcome variable or ROM measure. At final follow-up, patients with previous RCR had significantly lower ASES (76.5 [95% CI, 71.2-81.7] vs 85.0 [82.6-87.5], P = .015), lower SSV (76 [72-81] vs 86 [83-88], P < .001), worse pain (2.0 [1.4-2.6] vs 0.9 [0.6-1.1], P < .001), and less improvement in the ASES, ASES ADL, VAS, SSV, and forward elevation measures than controls. Multivariable linear regression analysis demonstrated that previous RCR was significantly associated with lower postoperative ASES score ( B = –9.5, P < .001), lower ASES improvement ( B = –7.9, P = .012), worse postoperative pain ( B = 0.9, P = .001), worse improvement in pain ( B = –1.0, P = .011), lower postoperative SSV ( B = –9.2, P < .001), lower SSV improvement ( B = –11.1, P = .003), and lower forward elevation ROM improvement ( B = –12.7, P = .008). Conclusion: Patients with previous RCR attempts may experience fewer short-term gains in functional and subjective outcome scores after RTSA compared with patients with no history of shoulder surgery who undergo RTSA. However, the differences between groups were small and below the minimal clinically important differences for the outcome measures analyzed.

scholarly journals Clinical Outcomes After Arthroscopic Double-Row Rotator Cuff Repair and Evaluation of Cuff Integrity by CT Arthrography

2009 ◽  
Vol 12 (2) ◽  
pp. 199-206
Author(s):  
Chris H. Jo ◽  
Je-Kyoon Kim ◽  
Kang-Sup Yoon ◽  
Ji-Ho Lee ◽  
Seung-Baek Kang ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Clinical Outcomes ◽  
Rotator Cuff Repair ◽  
Double Row ◽  
Ct Arthrography ◽  
Cuff Repair

MRI and MR arthrography in the assessment of the size of rotator cuff tear

1995 ◽  
Vol 4 ◽  
pp. S72
Author(s):  
H. Minagawa ◽  
E. Itoi ◽  
T. Kobayashi ◽  
T. Sato ◽  
Y. Shimada ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Mr Arthrography ◽  
Cuff Tear

Common upper limb musculoskeletal lesions

2018 ◽  
pp. 595-604
Author(s):  
Gavin Clunie ◽  
Nick Wilkinson ◽  
Elena Nikiphorou ◽  
Deepak R. Jadon
Keyword(s):  
Rotator Cuff ◽  
Upper Limb ◽  
Glenohumeral Joint ◽  
Tennis Elbow ◽  
Adhesive Capsulitis ◽  
Lateral Epicondylitis ◽  
Glenohumeral Instability ◽  
Suprascapular Notch ◽  
Long Head ◽  
Musculoskeletal Lesions

This chapter introduces readers to some common upper limb musculoskeletal lesions, including subacromial (shoulder) impingement syndrome, adhesive capsulitis, and lateral epicondylitis (tennis elbow). The epidemiology, aetiopathogenesis, clinical presentation, and management of these conditions are presented. Algorithms for their management are provided. Other disorders presenting with a subacromial impingement pattern of pain are detailed and optimal diagnostic imaging methods proposed. These include supraspinatus/cuff tendonitis, subacromial bursitis, rotator cuff tear, long head of biceps tendonitis, osteophyte impingement on the rotator cuff tendon, glenohumeral instability due to labral trauma (e.g. SLAP lesion), arthritis of the glenohumeral joint, enthesitis related to spondyloarthritis, and lesions at the suprascapular notch.

scholarly journals Impact of symptom bilaterality and hand dominance on patient-reported disability outcomes

2018 ◽  
Vol 6 ◽  
pp. 205031211879756
Author(s):  
Helen Razmjou ◽  
Tim Dwyer ◽  
Richard Holtby
Keyword(s):  
Risk Factors ◽  
Rotator Cuff ◽  
Outcome Measures ◽  
Rotator Cuff Tear ◽  
Glenohumeral Joint ◽  
Impingement Syndrome ◽  
Older Age ◽  
Hand Dominance ◽  
Cuff Tear ◽  
Dominant Side

Objectives: It is not clear if using patients with bilateral symptoms would impact the level of disability reported in orthopaedic research. The purposes of this study were to (1) examine the prevalence of bilateral shoulder symptoms (significant pain, stiffness or weakness affecting function) in patients with rotator cuff impingement syndrome, rotator cuff tear and osteoarthritis of the glenohumeral joint, (2) explore risk factors associated with bilateral shoulder symptoms, and (3) examine the impact of symptom bilaterality and hand dominance on pre- and post-operative patient-oriented disability outcomes. Methods: This study involved secondary analysis of prospectively collected data of patients who had undergone shoulder surgery and had returned for their 1-year follow-up. Two outcome measures were collected prior to surgery and at 1-year following surgery: the American Shoulder and Elbow Surgeons and the Constant–Murley Score. Results: Data of 772 patients, 376 (49%) females, 396 males (51%); 288 (impingement syndrome), 332 (rotator cuff tear), and 152 (osteoarthritis) were included in the analysis. There was a statistically significant difference in the prevalence of bilateral symptoms being 44%, 28%, and 22% in the osteoarthritis, impingement syndrome, and rotator cuff tear groups, respectively (p < 0.0001). The prevalence of dominant side involvement was 71%, 67%, and 53% in the rotator cuff tear, impingement syndrome, and osteoarthritis groups (p < 0.0001). Older age and female sex were risk factors for development of bilateral symptoms only in patients with rotator cuff tear. Neither symptom bilaterality nor dominant arm involvement had a negative impact on patient-oriented disability outcome measures prior to or after surgery (p > 0.05). Conclusion: This study shows that patients with osteoarthritis of the glenohumeral joint have the highest prevalence of bilateral shoulder complaints. The older age and the female sex increased the risk of having bilateral symptoms in patients with rotator cuff tear. Having bilateral shoulder symptoms or dominant side involvement was not associated with higher level of disability prior or after surgery.

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