scholarly journals Rotator Interval Lesion and Damaged Subscapularis Tendon Repair in a High School Baseball Player

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Tomoyuki Muto ◽  
Hiroki Ninomiya ◽  
Hiroaki Inui ◽  
Masahiko Komai ◽  
Katsuya Nobuhara
Keyword(s):  
Tendon Repair ◽  
Limited Range ◽  
High Signal ◽  
Subscapularis Tendon ◽  
Rotator Interval ◽  
Glenohumeral Ligaments ◽  
Limited Range Of Motion ◽  
Arthroscopic Examination ◽  
Magnetic Resonance Imaging Mri ◽  
One Year

In 2013, a 16-year-old baseball pitcher visited Nobuhara Hospital complaining of shoulder pain and limited range of motion in his throwing shoulder. High signal intensity in the rotator interval (RI) area (ball sign), injured subscapularis tendon, and damage to both the superior and middle glenohumeral ligaments were identified using magnetic resonance imaging (MRI). Repair of the RI lesion and partially damaged subscapularis tendon was performed in this pitcher. During surgery, an opened RI and dropping of the subscapularis tendon were observed. The RI was closed in a 90° externally rotated and abducted position. To reconfirm the exact repaired state of the patient, arthroscopic examination was performed from behind. However, suture points were not visible in the >30° externally rotated position, which indicates that the RI could not be correctly repaired with the arthroscopic procedure. One year after surgery, the patient obtained full function of the shoulder and returned to play at a national convention. Surgical repair of the RI lesion should be performed in exactly the correct position of the upper extremity.

scholarly journals Oral prednisolone administration in postoperative period improves results of TKA in patient with severe range of motion limitation – a paired outcome study

2020 ◽  
Author(s):  
Dariusz Grzelecki ◽  
Jacek Kowalczewski ◽  
Bartłomiej Kordasiewicz ◽  
Marcin Sibinski ◽  
Łukasz Olewnik ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Postoperative Period ◽  
Oral Prednisolone ◽  
Functional Results ◽  
Clinical Score ◽  
Limited Range ◽  
Functional Score ◽  
Limited Range Of Motion ◽  
Postoperative Time ◽  
One Year

Abstract Background One of the most common problems related to total knee arthroplasty (TKA) is postoperatively limited range of motion, especially in the most difficult cases. The aim of the study was to assess the influence of oral use of prednisolone in the postoperative period on the final results in a patient after TKA with severely limited postoperative range of motion. Methods Thirty-two patients (32 knees) with a mean age of 61.2 years were selected from our prospectively-collected data base with severe knee range of motion limitation (rheumatoid arthritis, psoriasis, ankylosing spondylitis, posttraumatic and postoperative osteoarthritis). Prednisolone was administrated in two doses per day (1 mg per kg of body mass) and then the dose was slowly reduced for no more than three months. Results The prednisolone group demonstrated significantly better results one year after the operation than the non-prednisolone group in terms of range of motion (mean extension 0.5˚ and 3.0˚; p=0.02, mean flexion 100.1˚ and 88˚; p= 0.01), WOMAC (mean 85.0 and 76.8 points; p=0.02) and KSS clinical score (mean 86.9 and 81.7; p=0.001) and KSS functional score (79.3 and 71.0 points; p=0.01). No significant differences were observed between the groups in terms of postoperative systemic and surgical site complications; therefore, no complications could be defined as steroid related. Conclusions The administration of oral prednisolone for a longer postoperative time in patients with severe preoperative range of motion following TKA significantly improves functional results without steroid related complications at one year follow-up.

scholarly journals Differential Diagnosis of a Glenoid Cyst in Omarthrosis: Hemangioma of the Glenoid – Resection and Reconstruction Using Autologous Bone-Graft and Special Implant

2020 ◽  
pp. 1-4
Author(s):  
Marius Junker ◽  
Jörn Kircher ◽  
Marius Junker ◽  
Milad Farkhondeh-Fal
Keyword(s):  
Clinical Manifestations ◽  
Autologous Bone Graft ◽  
Limited Range ◽  
Benign Tumors ◽  
Left Shoulder ◽  
Resonance Imaging ◽  
Limited Range Of Motion ◽  
Glenohumeral Osteoarthritis ◽  
Magnetic Resonance Imaging Mri ◽  
Typical Localization

Hemangiomas belong to the benign tumors, that can occur in any bone of the human body. The typical localization are the vertebral spine and the skull. There is no reported case of an intraarticular glenoidal hemangioma so far. The current paper presents a case of a 48-year-old female with joint pain that started 2 years before. The clinical manifestations included limited range of motion (ROM) and load dependent, non-load dependent and night pain. Roentgenogram and magnetic resonance imaging (MRI) of the left shoulder showed degenerative changes of the glenohumeral cartilage and a big (11.8mm x 10.3 mm) intraglenoidal mass affecting the joint line. The postoperative pathological diagnosis was that of a cavernous hemangioma. The aim of the present study was to present the imaging presentation of glenoidal hemangioma and to show therapeutic options in case of glenohumeral osteoarthritis (OA) with glenoidal bone loss due to hemangioma. In the present case no recurrence of the hemangioma and no complications of the implant in terms of loosening, infection or consisting were observed.

scholarly journals Imaging Review of Subscapularis Tendon and Rotator Interval Pathology

2022 ◽  
Vol 2022 ◽  
pp. 1-9
Author(s):  
Zohaib Y. Ahmad ◽  
Luis E. Diaz ◽  
Frank W. Roemer ◽  
Ajay Goud ◽  
Ali Guermazi
Keyword(s):  
Rotator Cuff ◽  
Glenohumeral Joint ◽  
Supraspinatus Tendon ◽  
Tendon Injury ◽  
Subscapularis Tendon ◽  
Rotator Interval ◽  
Biceps Pulley ◽  
Magnetic Resonance Imaging Mri ◽  
Tendon Pathology ◽  
Patterns Of Injury

As the largest rotator cuff muscle, the subscapularis plays a major role in stabilizing the glenohumeral joint, in conjunction with surrounding rotator cuff structures. Injury to the subscapularis tendon can be isolated, but more commonly is seen in conjunction with supraspinatus tendon pathology. Injury can be associated with biceps pulley instability, superior labral anterior-posterior (SLAP) tears, humeral head subluxation, and anterosuperior and coracoid impingements. The involvement of the rotator interval can lead to what is called “the hidden lesion,” due to its difficulty to diagnose during arthroscopy. Understanding the anatomical relations of the subscapularis tendon with the rest of the rotator cuff and rotator interval, as well as common patterns of injury that involve the subscapularis tendon, can aid in proper diagnosis of these injuries leading to prompt surgical repair. This review describes the anatomy of the subscapularis muscle and tendon, and the magnetic resonance imaging (MRI) patterns of subscapularis tendon injury.

scholarly journals Oral prednisolone administration in postoperative period improves results of TKA in patient with severe range of motion limitation – a paired outcome study

2020 ◽  
Author(s):  
Dariusz Grzelecki ◽  
Jacek Kowalczewski ◽  
Bartłomiej Kordasiewicz ◽  
Marcin Sibinski ◽  
Łukasz Olewnik ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Postoperative Period ◽  
Oral Prednisolone ◽  
Functional Results ◽  
Clinical Score ◽  
Limited Range ◽  
Functional Score ◽  
Limited Range Of Motion ◽  
Postoperative Time ◽  
One Year

Abstract Background. One of the most common problems related to total knee arthroplasty (TKA) is postoperatively limited range of motion, especially in the most difficult cases. The aim of the study was to assess the influence of oral use of prednisolone in the postoperative period on the final results in a patient after TKA with severely limited postoperative range of motion.Methods. Thirty-two patients (32 knees) with a mean age of 61.2 years were selected from our prospectively-collected data base with severe knee range of motion limitation (rheumatoid arthritis, psoriasis, ankylosing spondylitis, posttraumatic and postoperative osteoarthritis). Prednisolone was administrated in two doses per day (1 mg per kg of body mass) and then the dose was slowly reduced for no more than three months. Results. The prednisolone group demonstrated significantly better results one year after the operation than the non-prednisolone group in terms of range of motion (mean extension 0.5˚ and 3.0˚; p=0.02, mean flexion 100.1˚ and 88˚; p= 0.01), WOMAC (mean 85.0 and 76.8 points; p=0.02) and KSS clinical score (mean 86.9 and 81.7; p=0.001) and KSS functional score (79.3 and 71.0 points; p=0.01). No significant differences were observed between the groups in terms of postoperative systemic and surgical site complications; therefore, no complications could be defined as steroid related. Conclusions. The administration of oral prednisolone for a longer postoperative time in patients with severe preoperative range of motion following TKA significantly improves functional results without steroid related complications at one year follow-up.

Impairment Tutorial: Rating Tears of the Acetabular Labrum

2006 ◽  
Vol 11 (6) ◽  
pp. 4-7
Author(s):  
Charles N. Brooks ◽  
Richard E. Strain ◽  
James B. Talmage
Keyword(s):  
Magnetic Resonance ◽  
Hip Arthroscopy ◽  
Age Groups ◽  
Limited Range ◽  
Labral Repair ◽  
X Rays ◽  
Joint Stability ◽  
Acetabular Labrum ◽  
Complete Excision ◽  
Limited Range Of Motion

Abstract The primary function of the acetabular labrum, like that of the glenoid, is to deepen the socket and improve joint stability. Tears of the acetabular labrum are common in older adults but occur in all age groups and with equal frequency in males and females. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, is silent about rating tears, partial or complete excision, or repair of the acetabular labrum. Provocative tests to detect acetabular labrum tears involve hip flexion and rotation; all rely on production of pain in the groin (typically), clicking, and/or locking with passive or active hip motions. Diagnostic tests or procedures rely on x-rays, conventional arthrography, computerized tomography, magnetic resonance imaging (MRI), magnetic resonance arthrography (MRA), and hip arthroscopy. Hip arthroscopy is the gold standard for diagnosis but is the most invasive and most likely to result in complications, and MRA is about three times more sensitive and accurate in detecting acetabular labral tears than MRI alone. Surgical treatment for acetabular labrum tears usually consists of arthroscopic debridement; results tend to be better in younger patients. In general, an acetabular labral tear, partial labrectomy, or labral repair warrants a rating of 2% lower extremity impairment. Evaluators should avoid double dipping (eg, using both a Diagnosis-related estimates and limited range-of-motion tests).

The Correlation of the Limitations of Movement of the Shoulder Joint with the Functional Ability of Frozen Shoulder Patients at the Medical Rehabilitation Institute Dr. Mohammad Hoesin Palembang

2020 ◽  
Vol 3 (3) ◽  
pp. 88-96
Author(s):  
Ine Sintia ◽  
Nyimas Fatimah
Keyword(s):  
Functional Ability ◽  
Shoulder Joint ◽  
Frozen Shoulder ◽  
Limited Range ◽  
Medical Rehabilitation ◽  
Cross Sectional ◽  
Shoulder Joints ◽  
Limited Range Of Motion ◽  
Active Flexion ◽  
Cross Sectional Design

Background: Frozen shoulder is a condition of the shoulder joint that experiences inflammation, pain, adhesions, atrophyand shortening of the joint capsule resulting in limited motion. In frozen shoulder patients, the limited range of motion ofthe shoulder joint can affect and reduce functional ability. This study aims to analyze the correlation between the limitedarea of motion of the shoulder joint with the functional ability of frozen shoulder patients at the Medical RehabilitationInstallation Dr. Mohammad Hoesin Palembang. Methods: This study was an observational analytic study, correlationtest, with a cross sectional design. There were 29 frozen shoulder patients who met the inclusion criteria in the MedicalRehabilitation Installation Dr. Mohammad Hoesin Palembang in November 2018 was taken as a sample using consecutivesampling techniques. Functional ability was assessed using the quickDASH questionnaire and the area of motion wasmeasured using a goniometer, then analyzed. Results: The results of the correlation test showed significant resultsbetween functional abilities and the area of motion of the shoulder joints. Active flexion (p = 0.000; r = -0.669), activeextension (p = 0.004; r = -0.520), active abduction (p = 0.000; r = -0.663), active adduction (p = 0.022; r = -0.423 ), passiveflexion (p = 0.001; r = -0.589), passive extension (p = 0.002; r = -0.543), passive abduction (p = 0.000; r = -0.676), passiveadduction (p = 0.038; r = -0.388). Conclusion: There is a significant correlation between limited joint motion andfunctional ability in frozen shoulder patients at the Medical Rehabilitation Installation of Dr. Mohammad HoesinPalembang

Magnetic resonance imaging of spinal arteriovenous malformations

1987 ◽  
Vol 66 (6) ◽  
pp. 830-834 ◽  
Author(s):  
John L. Doppman ◽  
Giovanni Di Chiro ◽  
Andrew J. Dwyer ◽  
Joseph L. Frank ◽  
Edward H. Oldfield
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Arteriovenous Malformations ◽  
High Signal ◽  
Resonance Imaging ◽  
Content Type ◽  
Spinal Arteriovenous Malformations ◽  
Magnetic Resonance Imaging Mri ◽  
Spinal Avm ◽  
Fine Print

✓ Magnetic resonance imaging (MRI) was performed on 12 patients with spinal arteriovenous malformations (AVM's). Six lesions were intramedullary, five were dural, and one was in a posterior extramedullary location. Serpentine filling defects similar to the classic myelographic findings were demonstrated within the high-signal cerebrospinal fluid on T2-weighted coronal scans. The intramedullary nidus was identified by MRI as an area of low-signal intensity within the cord in all six intramedullary AVM's. Neither the dural nor the posterior extramedullary lesions showed intramedullary components. It is concluded that MRI may noninvasively provide the initial diagnosis of a spinal AVM and distinguish intramedullary from dural and extramedullary lesions.

scholarly journals Methomyl poisoning presenting with decorticate posture and cortical blindness

2014 ◽  
Vol 6 (1) ◽  
Author(s):  
Chih-Ming Lin
Keyword(s):  
Brain Mri ◽  
Vital Signs ◽  
Altered Mental Status ◽  
Cortical Blindness ◽  
High Signal ◽  
Blurred Vision ◽  
Cerebral Disease ◽  
Cerebral Magnetic Resonance Imaging ◽  
Neurological Effects ◽  
Magnetic Resonance Imaging Mri

Methomyl is a potent pesticide that is widely used in the field of agriculture. The systemic toxic effects of methomyl have been well described. However, the neurological effects of methomyl intoxication are not well understood. In this study, we report a 61-year-old Taiwanese man sent to our emergency department because of altered mental status. His family stated that he had consumed liquid methomyl in a suicide attempt. He was provided cardiopulmonary resuscitation because of unstable vital signs. He was then sent to an intensive care unit for close observation. On the second day of admission, he regained consciousness but exhibited irregular limb and torso posture. On the sixth day, he started to complain of blurred vision. An ophthalmologist was consulted but no obvious abnormalities could be identified. On suspicion of cerebral disease, a neurologist was consulted. Further examination revealed cortical blindness and decorticate posture. Cerebral magnetic resonance imaging (MRI) was arranged, which identified bilateral occipital regions lesions. The patient was administered normal saline and treated with aspirin and piracetam for 3 weeks in hospital. During the treatment period, his symptom of cortical blindness resolved, whereas his decorticate posture was refractory. Follow-up brain MRI results supported our clinical observations by indicating the disappearance of the bilateral occipital lesions and symmetrical putaminal high signal abnormalities. In this article, we briefly discuss the possible mechanisms underlying the cerebral effects of methomyl poisoning. Our study can provide clinicians with information on the manifestations of methomyl intoxication and an appropriate treatment direction.

P080 Acroosteolysis: a rare complication or a co-occurrence with Juvenile Idiopathic Arthritis?

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_5) ◽  
Author(s):  
Makhlouf Yasmine ◽  
Miladi Saoussen ◽  
Fazaa Alia ◽  
Sellami Mariem ◽  
Souabni Leila ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Psoriatic Arthritis ◽  
Rare Complication ◽  
Plain Radiograph ◽  
Limited Range ◽  
Acute Phase Reactants ◽  
Limited Range Of Motion ◽  
Macular Rash ◽  
Oligoarticular Juvenile Idiopathic Arthritis ◽  
Dysmorphic Syndrome

Abstract Background Acroosteolysis refers to a destructive process involving the distal phalanges of the fingers and toes that may extend to metacarpals or metatarsals. Rarely idiopathic, the diagnosis of primary acroosteolysis requires ruling out other causes. Juvenile idiopathic arthritis is an exceptional aetiology of acroosteolysis occurring mainly in psoriatic arthritis. Here by a case of juvenile idiopathic arthritis associated with acroosteolysis of the toes. Methods A 13-year-old girl with no past medical history, presented to our department of rheumatology with oligoarthritis affecting both wrists and knees. She had no familiar history of psoriasis nor rheumatic diseases. She described a dull ache and recurring swelling of knees evolving for >6 years associated with a macular rash of the chest without fever. On examination, the knees were swollen with a limited range of motion of < 90°. Examination of the spine and sacroiliac joints was unremarkable. There was no deformity, no dysmorphic syndrome nor ligamentous hyper laxity. The mucocutaneous examination was normal. Similarly, there was no hepatosplenomegaly or swollen lymph nodes. Laboratory investigations showed high acute phase reactants and normal blood count. Rheumatoid factor, anti-cyclic citrullinated peptide antibodies and antinuclear antibodies were also negative. Besides, she was negative for HLAB-27. Ophthalmic examination did not show any sequelae of uveitis. Results Plain radiograph of the feet revealed bone resorption of the second and fifth distal phalanges without signs of reconstruction. Other secondary causes of acroosteolysis were ruled out. The diagnosis of oligoarticular juvenile idiopathic arthritis was made. In view of the involvement of the distal phalanges, the phenotype of psoriatic arthritis was probable. The patient was initially treated with non-steroidal anti-inflammatory drugs as well as intraarticular injections of corticosteroids in knees. As the flares persisted, she was put on Methotrexate at a dosage of 15 mg per week with marked clinical improvement. Conclusion Our case illustrates a possible occurrence of acroosteolysis of the feet in the field of an active juvenile idiopathic arthritis. It is important to rule out other causes and make a rapid diagnosis in order to ensure appropriate management decisions.

Arthroscopic Subscapularis Tendon Repair Using the Mason-Allen Technique

2021 ◽  
Author(s):  
Junqi Huang ◽  
Jiajia Cheng ◽  
Shitian Tang ◽  
Bo Shi ◽  
Gang Liu ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Tendon Repair ◽  
Shoulder Function ◽  
Arthroscopic Rotator Cuff Repair ◽  
Subscapularis Tendon ◽  
Function Recovery ◽  
The Mean ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

Abstract Background Arthroscopic rotator cuff repair has recently been popularized for treating tears. In a biomechanical trial, the Mason-Allen stitch improved the fixation quality of poorly vascularized tendons. The use of this technique involving the subscapularis tendon remains rare. The aim of this study was to evaluate the clinical outcomes of Mason-Allen technique repaired subscapularis tendons. Methods A retrospective research of collected data from 98 patients with subscapularis tears who had undergone arthroscopic repair between May 2015 and December 2018. There were 75 males and 23 females. The mean age was 56.4 ± 9.6 years and the mean follow-up was 12.5 ± 4.0 months. The visual analog scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, and Constant-Murley score were used to analyze shoulder function. An MRI was performed to assess the integrity of the repair. Results Patients had significantly less pain and a better active range of motion compared with preoperative levels. VAS improved significantly from a preoperative mean of 3.42 to a postoperative mean of 1.91. ASES increased significantly from the preoperative mean of 43.6 to the postoperative mean of 74.5. Seven cases suffered from retears, which were confirmed by an MRI examination. Conclusion Arthroscopic rotator cuff repair with the Mason-Allen method resulted in a decreased level of pain and satisfied function recovery.

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