Ultrasonographic Evaluation of the Shoulder in Elite Wheelchair Tennis Players

2010 ◽  
Vol 19 (2) ◽  
pp. 161-172 ◽  
Author(s):  
In-Ho Jeon ◽  
Hemanshu Kochhar ◽  
Jong-Min Lee ◽  
Hee-Soo Kyung ◽  
Woo-Kie Min ◽  
...  
Keyword(s):  
High Resolution ◽  
Rotator Cuff ◽  
Outcome Measures ◽  
Day Length ◽  
Rotator Cuff Tears ◽  
Shoulder Injuries ◽  
Tennis Players ◽  
Shoulder Pathology ◽  
Linear Probe ◽  
High Resolution Ultrasonography

Context:Wheelchair tennis has been identified as a high-risk sport for shoulder injury, so understanding shoulder pathology in these athletes is important.Objective:This study investigated the incidence and pattern of shoulder injuries in wheelchair tennis players using high-resolution ultrasonography.Design:Descriptive study.Setting:International Wheelchair Tennis Open.Participants:33 elite-level wheelchair tennis players.Outcome Measures:Wheelchair tennis players completed a self-administered questionnaire, and shoulders of each athlete were investigated using high-resolution ultrasonography (linear probe 7.5 MHz).Results:The most common pathology in the dominant shoulder was acromioclavicular pathology, in 21 players (63.6%). Full-thickness rotator-cuff tears involving the supraspinatus were found in 8 dominant shoulders and 6 nondominant shoulders. There were no correlations between identified shoulder pathology and the different variables studied, such as age, training time per day, length of wheelchair use, and length of career as a wheelchair tennis player.Conclusion:High prevalence of rotator-cuff and acromioclavicular pathology was found by ultrasonographic examination in the elite wheelchair tennis players in both dominant and nondominant shoulders. A high index of suspicion of these pathologies in wheelchair athletes is required.

Shoulder MRI in asymptomatic elite volleyball athletes shows extensive pathology

2019 ◽  
Vol 5 (1) ◽  
pp. 10-14 ◽  
Author(s):  
Christopher Sy Lee ◽  
Nicole Hamilton Goldhaber ◽  
Shane M Davis ◽  
Michelle L Dilley ◽  
Aaron Brock ◽  
...  
Keyword(s):  
Los Angeles ◽  
Rotator Cuff ◽  
Shoulder Joint ◽  
Rotator Cuff Tears ◽  
Low Grade ◽  
Shoulder Injuries ◽  
Overhead Athletes ◽  
Shoulder Pathology ◽  
Volleyball Players ◽  
Elite Level

ObjectivesElite overhead athletes, such as volleyball players, are predisposed to shoulder injuries due to repetitive overhead movement and overloading of the shoulder joint and surrounding muscles and ligaments. Returning to play at an elite level following shoulder surgery is often not possible. We hypothesised that MRI of elite volleyball players’ dominant shoulders would demonstrate extensive asymptomatic shoulder pathology that does not prevent the athlete from competing. To test this hypothesis, the objective of this observational study was to evaluate the history, physical examination and MRI findings to determine the incidence of asymptomatic shoulder pathology. We believe this knowledge will improve outcomes in the management of shoulder pain in overhead athletes and prevent unnecessary surgical procedures.Methods26 asymptomatic elite volleyball players of the US Men’s and Women’s National Indoor Volleyball Teams underwent MRI (0.27 Tesla) of their dominant shoulders and physical examinations of both shoulders. Asymptomatic was defined as being able to play volleyball without restrictions. The imaging was reviewed by two fellowship-trained musculoskeletal radiologists. Visual Analogue Pain scores, range of motion, strength, University of California, Los Angeles and American Shoulder and Elbow Society outcome scores were measured and recorded.ResultsThe mean age at the time of MRI was 25.53 years old (range: 21 to 30 years). There were 14 male and 12 female players. 23 athletes had rotator cuff tendinosis (88.5%) and 17 athletes had partial rotator cuff tears (65.4%). 13 of these tears involved the supraspinatus with five moderate-to-high-grade and eight moderate-to-low-grade. Two tears involved the infraspinatus, and there were two subscapularis tears. Six athletes had a labral tear (23.1%) and six additional athletes had labral fraying (23.1%). All MRIs showed abnormal pathology.ConclusionThese findings support the notion that elite-level volleyball players display asymptomatic shoulder joint pathology in their dominant arm, particularly of the rotator cuff and labrum, which do not limit their ability to participate.Level of evidenceV

Accuracy of High-Resolution Ultrasonography in the Diagnosis of Articular-Sided Partial Thickness Rotator Cuff Tears

2010 ◽  
Vol 2 (4) ◽  
pp. 267-270 ◽  
Author(s):  
Chetan S. Modi ◽  
Christopher D. Smith ◽  
Kevin Ho ◽  
Shanmugam Karthikeyan ◽  
Santosh Rai ◽  
...  
Keyword(s):  
High Resolution ◽  
Rotator Cuff ◽  
Rotator Cuff Tears ◽  
Partial Thickness ◽  
High Resolution Ultrasonography

scholarly journals Can ultrasound suffice for triaging patients requiring surgical correction of rotator cuff tears—a comparative evaluation of ultrasound and magnetic resonance imaging

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Aniket Agarwal ◽  
Kavita Vani ◽  
Anurag Batta ◽  
Kavita Verma ◽  
Shishir Chumber
Keyword(s):  
Rotator Cuff ◽  
Biceps Tendon ◽  
Surgical Correction ◽  
Statistical Testing ◽  
Rotator Cuff Tears ◽  
Full Thickness ◽  
Partial Thickness ◽  
Linear Probe ◽  
Significant Difference ◽  
Sensitivity Specificity

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.

scholarly journals The Impact of Smoking on Clinical Results Following the Rotator Cuff and Biceps Tendon Complex Arthroscopic Surgery

2021 ◽  
Vol 10 (4) ◽  
pp. 599
Author(s):  
Jan Zabrzyński ◽  
Gazi Huri ◽  
Maciej Gagat ◽  
Łukasz Łapaj ◽  
Alper Yataganbaba ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Functional Outcomes ◽  
Shoulder Arthroscopy ◽  
Smoking Status ◽  
Biceps Tendon ◽  
Arthroscopic Surgery ◽  
Rotator Cuff Tears ◽  
Shoulder Injuries ◽  
The Impact

The purpose of this study was to investigate the association of smoking and functional outcomes after arthroscopic treatment of complex shoulder injuries: rotator cuff tears (RCTs) with biceps tendon (LHBT) tears. This retrospective case-control study has been conducted on a cohort of patients who underwent shoulder arthroscopy between 2015 and 2017 due to complex injury treatment. The outcomes were assessed using the American Shoulder and Elbow Surgeons Score (ASES), the University of California at Los Angeles (UCLA) Shoulder Score, need for non-steroid anti-inflammatory drugs (NSAIDs) consumption and the visual analog scale (VAS). Complications and changes in smoking status were also noted. A cohort of 59 patients underwent shoulder arthroscopy, due to complex LHBT pathology and RCTs, and were enrolled in the final follow-up examination; with mean duration of 26.03 months. According to smoking status, 27 of patients were classified as smokers, and the remaining 32 were non-smokers. In the examined cohort, 36 patients underwent the LHBT tenotomy and 23 tenodesis. We observed a relationship between smoking status and distribution of various RCTs (p < 0.0001). The mean postoperative ASES and UCLA scores were 80.81 and 30.18 in the smoker’s group and 84.06 and 30.93 in the non-smoker’s group, respectively. There were no statistically significant differences in pre/postoperative ASES and postoperative UCLA scores between smokers and non-smokers (p > 0.05). The VAS was significantly lower in the non-smokers’ group (p = 0.0021). Multi-tendon injuries of the shoulder are a serious challenge for surgeons, and to obtain an excellent functional outcome, we need to limit the negative risk factors, including smoking. Furthermore, there is a significant association between smoking and the occurrence of massive rotator cuff tears, and the pain level measured by the VAS. Simultaneous surgical treatment of RC and LHBT lesions in the smoker population allowed us to obtain the functional outcomes approximated to non-smokers in the long-term follow-up. Of course, we cannot assert that smoking is the real cause of all complications, however, we may assume that this is a very important, negative factor in shoulder arthroscopy.

The role of high-resolution ultrasonography in management of calcific tendonitis of the rotator cuff

2001 ◽  
Vol 27 (6) ◽  
pp. 735-743 ◽  
Author(s):  
Hong-Jen Chiou ◽  
Yi-Hong Chou ◽  
Jinn-Jer Wu ◽  
Tung-Fu Huang ◽  
Hsiao-Li Ma ◽  
...  
Keyword(s):  
High Resolution ◽  
Rotator Cuff ◽  
Calcific Tendonitis ◽  
High Resolution Ultrasonography

scholarly journals Title: IDENTIFYING THE AXILLARY NERVE DURING SHOULDER SURGERY: AN ANATOMIC STUDY USING ADVANCED IMAGING

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0003
Author(s):  
Michael E. Hachadorian ◽  
Brendon C. Mitchell ◽  
Matthew Y. Siow ◽  
Wilbur Wang ◽  
Tracey Bastrom ◽  
...  
Keyword(s):  
High Resolution ◽  
Rotator Cuff ◽  
Axillary Nerve ◽  
Small Sample ◽  
Shoulder Surgery ◽  
Rotator Cuff Tears ◽  
Large Sample Size ◽  
Musculoskeletal Radiology ◽  
Reconstructive Procedures ◽  
Mri Studies

Background: The axillary nerve (AXN) is one of the more commonly injured nerves during shoulder surgery. Prior anatomic studies of the AXN in adults were performed using cadaveric specimens with small sample sizes. Our research observes a larger cohort of magnetic resonance imaging (MRI) studies in order to gain a more representative sample of the course of the axillary nerve and aid surgeons intraoperatively. Methods: High-resolution 3T MRI studies performed at our institution from January 2010 to June 2019 were reviewed. Four blinded reviewers with musculoskeletal radiology or orthopaedic surgery training measured the distance of the AXN to the surgical neck of the humerus (SNH), the lateral tip of the acromion (LTA), and the inferior glenoid rim (IGR). Intra-class Correlation Coefficient (ICC) was calculated to assess reliability between reviewers. The nerve location was assessed relative to rotator cuff tear status. Results: A total of 257 shoulder MRIs were included. ICC was excellent at 0.80 for SNH, 0.90 for LTA and 0.94 for IGR. All intra-observer reliabilities were above 0.80. Mean distance from AXN to SNH was 1.7 cm (0.7-3.1 cm, IQR 1.38-2.00) and AXN to IGR was 1.6 cm (0.6-2.6 cm, IQR 1.33-1.88). The mean AXN to LTA distance was 7.1 cm, with a range of 5.2 to 9.0 cm across patient heights; there was a large effect size related to LTA to AXN distance and patient height with a correlation of r=0.603, (p<0.001). Rotator cuff pathology appears to affect nerve location by increasing the distance between AXN and SNH (p = 0.027). Discussion/Conclusion: The AXN is vulnerable to injury during both open and arthroscopic shoulder procedures. This injury can be either a result of direct trauma to the nerve or secondary to traction placed on the nerve with reconstructive procedures that distalize the humerus. Our study demonstrates that the axillary nerve can be found as little as 5.6 mm from IGR and 6.9 mm from the SNH. Additionally, we illustrate the relationship between patient height and LTA to AXN distance and complete rotator cuff tears and SNH to AXN distance. Our study is the first to demonstrate the nerve’s proximity to important surgical landmarks of the shoulder using a large sample size of high-resolution images in living human shoulders. Tables/Figures: [Figure: see text][Table: see text]

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