scholarly journals Ultrasonic Tenotomy and Debridement for Calcific Tendinopathy of the Shoulder: A Pilot Case Series

2020 ◽  
Vol 11 ◽  
pp. 215013272096466
Author(s):  
Jacob L. Erickson ◽  
Andrew R. Jagim
Keyword(s):  
Rotator Cuff ◽  
Sports Medicine ◽  
Treatment Options ◽  
Case Series ◽  
Invasive Treatment ◽  
Effective Treatment Option ◽  
Current Case ◽  
Calcific Tendinopathy ◽  
Pain Scores ◽  
Post Procedure

Calcific tendinopathy of the rotator cuff is a common cause of shoulder pain and debility. Minimally invasive treatment options have been employed for management; however, ultrasonic tenotomy has not been previously described for management of calcific tendinopathy of the shoulder. The purpose of the current case series was to provide preliminary evidence in support of a novel treatment modality for calcific tendinopathy of the rotator cuff. This descriptive pilot case series included a total of 8 patients with calcific tendinopathy of the supraspinatus that underwent ultrasound-guided ultrasonic debridement in the sports medicine clinic. All procedures were performed by the same physician (JLE). All patients had confirmation of the diagnosis with MRI and ultrasound imaging. Pain was measured pre-procedure and followed until 3-months post-procedure. Very large, statistically significant, reductions (P < .01) in pain scores were observed at 1 (ES = 1.93), 2 (ES = 1.84) and 3 (ES = 2.20) months post-procedure, respectively. All patients experienced a significant reduction in pain scores, regardless of hardness of the calcium deposit, at 1 month post-procedure with pain scores remaining lower than at baseline at 2 and 3 months post-procedure. No adverse events were noted in any patients. Ultrasonic tenotomy and debridement appears to be a safe and effective treatment option for patients with calcific tendinopathy of the supraspinatus.

scholarly journals Ultrasound-Guided Percutaneous Irrigation of Rotator Cuff Calcific Tendinopathy (US-PICT): Patient Experience

2020 ◽  
Vol 2020 ◽  
pp. 1-7 ◽  
Author(s):  
Domenico Albano ◽  
Angelo Gambino ◽  
Carmelo Messina ◽  
Vito Chianca ◽  
Salvatore Gitto ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Clinical Improvement ◽  
Ultrasound Guided ◽  
Chi Square ◽  
Calcific Tendinopathy ◽  
Pain Scores ◽  
Experienced Pain ◽  
Full Explanation ◽  
Reduction Of Pain ◽  
Patients Experience

Purpose. To assess patients’ experience of ultrasound-guided percutaneous irrigation of rotator cuff calcific tendinopathy (US-PICT). Methods. Ninety-one patients (58 females; mean age: 50.5±8.3 years) treated by US-PICT (local anesthesia, single-needle lavage, and intrabursal steroid injection) answered to a list of questions regarding their experience of the procedure before treatment, immediately after treatment, and three months later. The Borg CR10 scale was used to evaluate perceived pain, discomfort during anesthetic injection, and anxiety. The Wilcoxon, Spearman’s rho, linear regression, and chi-square statistics were used. Results. 81/91 patients complained mild discomfort during the injection of anesthetics (2, 1-2). Pain scores during US-PICT were very low (0, 0-1), with 70% patients having not experienced pain. After treatment, we found a significant reduction of pain (before: 8, 7-8; 3-month: 3, 1-6; p<.001) and anxiety (before: 5, 2-7; during treatment: 2, 1-7; p=0.010), with high overall satisfaction (immediately after: 10, 9-10; 3-month: 9, 7-10) and confidence in the possibility of recovery (immediately after: 9, 8-10; 3-month: 10, 8-10), respectively. Treatments performed before US-PICT were not statistically associated with pain relief (p=0.389) and clinical improvement (p=0.937). We found a correlation between satisfaction immediately postprocedure and confidence in the possibility of recovery (p=0.002) and between satisfaction three months after treatment and clinical improvement (p<0.001) and patients’ reminds about the description of the procedure (p=0.005) and of the potential complications (p=0.035). Conclusions. US-PICT is a mildly painful, comfortable, and well-tolerated procedure, regardless of any previous treatments. Patients’ satisfaction is correlated with clinical benefit and full explanation of the procedure and its complications.

scholarly journals Emergency Management of Paraphimosis

2003 ◽  
Vol 10 (4) ◽  
pp. 253-257 ◽  
Author(s):  
Ch Chung
Keyword(s):  
Case Reports ◽  
Data Extraction ◽  
Treatment Options ◽  
Case Series ◽  
Treatment Modalities ◽  
Invasive Treatment ◽  
Manual Search ◽  
Study Selection ◽  
Library Network ◽  
Randomised Controlled

Objective To review the treatment modalities available for paraphimosis, with special emphasis on those applicable to the emergency department. Data source Relevant medical literature was searched through MEDLINE, EMBASE, CINAHL, and Cochrane Database. Manual search was performed in books on Urology, General Surgery and Emergency Medicine available in the Hospital Library. Further information was obtained through the Internet at < www.infoseek.com >. References cited in articles were also retrieved. Study selection Key words for the literature, Internet and textbook search were ‘paraphimosis’ and ‘treatment’. All available years of study were reviewed. Data extraction Relevant full text articles were obtained through the hospital library network. Original articles, review papers, medical practice, case reports, and relevant book chapters were reviewed. Data synthesis There were no prospective, randomised, controlled studies available. The majority were case series and expert experience or opinions only. Currently, a multitude of non-invasive and invasive treatment options are available, including manual reduction, help of non-crushing tissue forceps, puncture technique and dorsal slit. Conclusion All treatment methods are within the capability of the emergency physician. Hospitalization should rarely be required, unless there are serious complications.

scholarly journals Clinical and Biomechanical Progression after Ankle Joint Distraction in a Young Adolescent Patient with Haemophilia

2021 ◽  
Vol 18 (21) ◽  
pp. 11405
Author(s):  
Nicolas Haelewijn ◽  
Sebastien Lobet ◽  
An Van Damme ◽  
Pierre-Louis Docquier ◽  
Maarten Eerdekens ◽  
...  
Keyword(s):  
Ankle Joint ◽  
Outcome Measures ◽  
Treatment Options ◽  
Pain Syndrome ◽  
Poor Response ◽  
Invasive Treatment ◽  
Current Case ◽  
Power Absorption ◽  
Skin Marker ◽  
Joint Distraction

Ankle joint distraction (AJD) has been described to be a valuable joint-sparing alternative to arthrodesis or arthroplasty; however, clinical endpoints associated to this surgical intervention are lacking. The current case report describes clinical and biomechanical outcome measures of ankle joint distraction in a 14-year-old patient with severe haemophilia A. Because of persistent and incapacitating pain and the poor response to conservative and invasive treatment options, ankle joint distraction was performed in this 14-year-old patient using an external fixator encompassing two Ilizarov full rings in the tibia and a foot ring fixed to the foot by four K-wires. State-of-the-art medical imaging and non-invasive skin marker-based 3D multi-segment foot modelling were performed in a pre- and post-operative stage. From a structural viewpoint, this AJD was a success since it improved and stabilised the osteo-cartilaginous lesions of the ankle. Biomechanical outcome measures associated with the 18-month follow-up were found to be suboptimal, showing an early plantarflexion pattern at the ankle joint during midstance and a tendency towards increased power absorption at the midfoot with peak power absorption being almost two times higher when compared to boys of the same age. From a functional viewpoint, we observed a clear reduction in the patients’ physical activities until one year after AJD. Despite these functional and structural improvements, recurrent painful phenomena, including the development of a complex regional pain syndrome (CRPS) and a stress fracture of the third metatarsal bone, were observed which are probably related with the development of recurrent subchondral oedema.

scholarly journals Retrospective study of sonographic findings in bone involvement associated with rotator cuff calcific tendinopathy: preliminary results of a case series

2015 ◽  
Vol 48 (6) ◽  
pp. 353-357 ◽  
Author(s):  
Marcello H. Nogueira-Barbosa ◽  
Everaldo Gregio-Junior ◽  
Mario Muller Lorenzato
Keyword(s):  
Computed Tomography ◽  
Retrospective Study ◽  
Rotator Cuff ◽  
Cortical Bone ◽  
Bone Erosion ◽  
Case Series ◽  
Bone Involvement ◽  
Calcific Tendinopathy ◽  
Calcific Tendonitis ◽  
Bone Abnormalities

Abstract Objective: The present study was aimed at investigating bone involvement secondary to rotator cuff calcific tendonitis at ultrasonography. Materials and Methods: Retrospective study of a case series. The authors reviewed shoulder ultrasonography reports of 141 patients diagnosed with rotator cuff calcific tendonitis, collected from the computer-based data records of their institution over a four-year period. Imaging findings were retrospectively and consensually analyzed by two experienced musculoskeletal radiologists looking for bone involvement associated with calcific tendonitis. Only the cases confirmed by computed tomography were considered for descriptive analysis. Results: Sonographic findings of calcific tendinopathy with bone involvement were observed in 7/141 (~ 5%) patients (mean age, 50.9 years; age range, 42-58 years; 42% female). Cortical bone erosion adjacent to tendon calcification was the most common finding, observed in 7/7 cases. Signs of intraosseous migration were found in 3/7 cases, and subcortical cysts in 2/7 cases. The findings were confirmed by computed tomography. Calcifications associated with bone abnormalities showed no acoustic shadowing at ultrasonography, favoring the hypothesis of resorption phase of the disease. Conclusion: Preliminary results of the present study suggest that ultrasonography can identify bone abnormalities secondary to rotator cuff calcific tendinopathy, particularly the presence of cortical bone erosion.

Combination rituximab and intravenous immunoglobulin for treatment of refractory vasculitic neuropathy: a case series

Rheumatology ◽  
2021 ◽  
Author(s):  
Kaitlin Lima ◽  
Jinny Tavee ◽  
Anisha Dua
Keyword(s):  
Medical Records ◽  
Treatment Options ◽  
Case Series ◽  
Ivig Therapy ◽  
Individual Treatment ◽  
Effective Treatment Option ◽  
Vasculitic Neuropathy ◽  
Risks And Benefits ◽  
Male Patients ◽  
Written Informed Consent

Abstract Objective Limited evidence exists to guide treatment of refractory vasculitic neuropathy. While rituximab (RTX) and IVIG have both been proposed as individual treatment options for these patients, combination therapy has never been reported. Methods Written informed consent was obtained from three patients with refractory vasculitic neuropathy who were treated with combination RTX and IVIG. Their electronic medical records were reviewed and clinical and functional outcomes were reported. Results Two male patients with non-systemic vasculitic neuropathy and one male patient with granulomatosis with polyangiitis were treated with combination RTX and IVIG therapy. All three patients demonstrated clinical improvement with at least partial functional recovery and a reduction in corticosteroid dose. This combination was generally well tolerated. Conclusions Combination RTX and IVIG therapy may be a safe and effective treatment option for patients with refractory vasculitic neuropathy. Further studies are needed to better characterize the risks and benefits of this combination.

scholarly journals An audit of hysterectomies: indications, complications and clinico pathological analysis of hysterectomy specimens in a tertiary care center

2018 ◽  
Vol 7 (9) ◽  
pp. 3689
Author(s):  
Vanithamani Sivapragasam ◽  
Chellammal K. Rengasamy ◽  
Aruna B. Patil
Keyword(s):  
Clinical Diagnosis ◽  
Surgical Procedure ◽  
Care Center ◽  
Treatment Options ◽  
Tertiary Care ◽  
Abnormal Uterine Bleeding ◽  
Bladder Injury ◽  
Histopathological Diagnosis ◽  
Invasive Treatment ◽  
Effective Treatment Option

Background: Hysterectomy is the commonest major surgical procedure performed in gynecology. It is an effective treatment option for many gynecological conditions. Aim and objective of the study was to analyse the indications, complications of hysterectomies and to see whether preoperative clinical diagnosis was confirmed by histopathology.Methods: Authors present a retrospective study of 198 hysterectomised cases over a period of one year from January 2016 to December 2016. The data regarding patients age, parity, indication for hysterectomy, type of hysterectomy, complications during and after surgery and final histopathological diagnosis were collected from the records and analysed.Results: A total of 198 cases of hysterectomies were studied. Hysterectomies were distributed over a wide age ranging from 32 years to 75 years. Most common age group was 41-50 years. Majority were done through abdominal route 162 cases (81%). Most common indication was abnormal uterine bleeding 56 (28%) and fibroid 41 (21%). One case of accidental bladder injury was noted. Most common postoperative complication was fever (23%). Most common histopathological lesion was fibroid 101 (51%). In three cases preoperative clinical diagnosis did not correlate with final histopathological diagnosis.Conclusions: As any surgical procedure, hysterectomy is also associated with risk of complications. Hence the indication should be carefully evaluated. Reporting of all hysterectomies should be made mandatory and audit results should be used for improvement of quality of health service. Newer and less invasive treatment options should be offered to women with benign pathologies. This will further reduce the incidence of hysterectomy.

scholarly journals Minimally Invasive Sacroiliac Joint Fusion: One-Year Outcomes in 40 Patients

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Donald Sachs ◽  
Robyn Capobianco
Keyword(s):  
Joint Pain ◽  
Facet Joint ◽  
Treatment Options ◽  
Case Series ◽  
Effective Treatment Option ◽  
Trochanteric Bursitis ◽  
Joint Fusion ◽  
One Year ◽  
Si Joint ◽  
Implant System

Background. SI joint pain is difficult to diagnose due to overlapping symptoms of the lumbar spine, and until recently, treatment options have been limited. The purpose of this retrospective study is to report on the safety and effectiveness of MIS SI joint arthrodesis using a series of triangular, porous plasma coated implants in patients refractory to conservative care.Methods. We report on the first 40 consecutive patients with one-year follow-up data that underwent MIS SI joint fusion with the iFuse Implant System (SI-BONE, Inc., San Jose, CA) by a single surgeon. Medical charts were reviewed for demographics, perioperative metrics, complications, pain scores, and satisfaction.Results. Mean age was 58 years (range 30–81) and 75% of patients were female. Postoperative complications were minimal and included transient trochanteric bursitis (5%), facet joint pain (20%), and new low back pain (2.5%). There were no reoperations at one year. Mean pain score improved from 8.7 (1.5 SD) at baseline to 0.9 (1.6) at 12 months, a 7.8-point improvement (P<.001). Patient satisfaction was very high.Conclusions. The results of this case series reveal that MIS SI joint fusion using the iFuse Implant System is a safe and effective treatment option in carefully selected patients.

Isolated Subscapularis Repair in Irreparable Posterosuperior Massive Rotator Cuff Tears Involving the Subscapularis Tendon

2017 ◽  
Vol 45 (6) ◽  
pp. 1269-1275 ◽  
Author(s):  
Sung-Jae Kim ◽  
Yun-Rak Choi ◽  
Min Jung ◽  
Won-Yong Lee ◽  
Yong-Min Chun
Keyword(s):  
Rotator Cuff ◽  
Structural Integrity ◽  
Young Patients ◽  
Case Series ◽  
Rotator Cuff Tears ◽  
Subscapularis Tendon ◽  
Massive Rotator Cuff Tears ◽  
Pain Scores ◽  
Shoulder Scores

Background: No previous study has examined whether isolated subscapularis tendon repair in irreparable posterosuperior massive rotator tears involving the subscapularis tendon in relatively young patients without arthritis can yield satisfactory outcomes. Hypothesis: We hypothesized that this procedure would produce favorable outcomes in patients who might otherwise be candidates for reverse arthroplasty. Study Design: Case series; Level of evidence, 4. Methods: This retrospective study included 24 patients in their 50s and 60s, without shoulder arthritis, who underwent arthroscopic isolated subscapularis repair for an irreparable massive rotator cuff tear involving the subscapularis tendon. Preoperative and postoperative visual analog scale (VAS) pain scores, subjective shoulder values (SSVs), University of California at Los Angeles (UCLA) shoulder scores, American Shoulder and Elbow Surgeons (ASES) scores, subscapularis strength (modified bell-press test; maximum of 5), and shoulder active range of motion (ROM) were assessed. Postoperative magnetic resonance arthrography (MRA) was performed 6 months postoperatively to assess structural integrity of the repaired subscapularis. Results: At a mean 34.8 months (range, 24-49 months) of follow-up, VAS pain scores (improved from 7.1 to 2.5), SSVs (33.3 to 75.2), ASES scores (35.9 to 76.0), UCLA shoulder scores (11.6 to 24.8), subscapularis strength, and ROM were significantly improved compared with preoperative measurements ( P < .001). Subscapularis muscle strength improved from 3.7 to 4.2 ( P < .001). For active ROM, forward flexion and internal rotation improved significantly ( P < .001); however, external rotation exhibited no significant improvement. Follow-up MRA was performed in 22 patients (92%) and showed retear of the repaired subscapularis in 6 (27% of the 22). Conclusion: Isolated repair of the subscapularis tendon in irreparable massive rotator cuff tears involving the subscapularis tendon yielded satisfactory short-term outcomes and structural integrity in patients in their 50s and 60s without arthritis. If patients with irreparable massive rotator cuff tears involving the subscapularis tendon are relatively young or have minimal concomitant arthritis, this repair can be worthwhile.

scholarly journals Miltefosine for Mucosal and Complicated Cutaneous Old World Leishmaniasis: A Case Series and Review of the Literature

2016 ◽  
Vol 3 (1) ◽  
Author(s):  
Vincent Mosimann ◽  
Claudia Blazek ◽  
Heini Grob ◽  
Matthew Chaney ◽  
Andreas Neumayr ◽  
...  
Keyword(s):  
Effective Treatment ◽  
Cutaneous Leishmaniasis ◽  
Clinical Studies ◽  
Systemic Treatment ◽  
Treatment Options ◽  
Case Series ◽  
Review Of The Literature ◽  
Effective Treatment Option ◽  
Old World ◽  
Mucosal Leishmaniasis

Abstract Complicated Old World cutaneous leishmaniasis (OWCL) and Old World mucosal leishmaniasis (OWML) constitute an indication for systemic treatment. To date, there no controlled clinical studies that compare treatment options for these diseases. We compiled a case series of 24 cases successfully treated with miltefosine. We conclude that oral miltefosine is an effective treatment option for both OWCL and OWML.

In-block lateralization as a new technique for mobilization of the inferior alveolar nerve: a technique case series

2020 ◽  
Author(s):  
Marcos Augusto Tomazi ◽  
Alexandre da Silveira Gerzson ◽  
Angelo Menuci Neto ◽  
André Luciano Pasinato da Costa
Keyword(s):  
Treatment Options ◽  
Inferior Alveolar Nerve ◽  
Case Series ◽  
New Technique ◽  
Autogenous Bone ◽  
Minimal Risk ◽  
Short Implants ◽  
Bone Atrophy ◽  
A New Technique ◽  
Number Of Treatment

The edentulous atrophic posterior mandible is often a great challenge for implant rehabilitation. Although a number of treatment options have been proposed, including the use of short implants and surgical grafting techniques, in cases of severe bone atrophy, techniques for mobilization of the inferior alveolar nerve (IAN) have been shown to be efficient, with good results. Four female patients underwent IAN lateralization for prosthetic rehabilitation of the posterior mandible from 2013 to 2019, with 1 year to 5 years and 4 months of follow-up. This case series describes a new technique for mobilization of the IAN, named in-block lateralization, to facilitate access to the IAN and to reduce nerve manipulation. The implant is immediately installed (allowing nerve lateralization in unitary spaces) and the original mandibular anatomy is restored with autogenous bone from the original bed during the same surgical procedure. When well indicated and well performed, this new approach provides better and easier visualization of the IAN as well as safer manipulation aiming to achieve good results for implant stability and minimal risk of neurosensory disturbances, allowing rehabilitation even in unitary spaces.

Sign in / Sign up

Export Citation Format

Share Document