scholarly journals 75-year-old woman • right-side rib pain • radiating shoulder pain • history of hypertension & hypercholesterolemia • Dx?

2021 ◽  
Vol 70 (8) ◽  
Author(s):  
Albertson
Medicina ◽  
2020 ◽  
Vol 57 (1) ◽  
pp. 29
Author(s):  
Yuta Suzuki ◽  
Noriaki Maeda ◽  
Junpei Sasadai ◽  
Kazuki Kaneda ◽  
Taizan Shirakawa ◽  
...  

Background and objectives: The long head of the biceps (LHB) and rotator cuff tendinopathy is the major cause of shoulder pain in competitive swimmers. The risk of tendinopathy increases with aging; however, the structural changes of LHB and rotator cuff in populations of masters swimmers have not been well examined. The purpose of this study was to investigate the prevalence of ultrasonographic abnormalities of the shoulders in masters swimmers, and the association of pain, age, and swim training with structural changes in this population. Materials and Methods: A total of 60 subjects participated in this study, with 20 masters swimmers with shoulder pain, 20 asymptomatic masters swimmers, and 20 sex- and age-matched controls. All swimmers completed a self-reported questionnaire for shoulder pain, their history of competition, and training volume. Each subject underwent ultrasonographic examination of both shoulders for pathologic findings in the LHB tendon, rotator cuff (supraspinatus (SSP) and subscapularis (SSC)) tendons, and subacromial bursa (SAB) of both shoulders and had thickness measured. Results: The prevalence of tendinosis (LHB, 48.8%; SSP, 17.5%; SSC, 15.9%), partial tear (SSP, 35.0%), and calcification (SSC, 10.0%) were higher in swimmers than in controls. LHB and SSP tendinosis were associated with shoulder pain. Older age and later start of competition were associated with an increased risk of LHB tendinosis and SSC calcification. Earlier initiation of swimming and longer history of competition were associated with an increased risk of SSP and SSC tendinosis. The thicker SSP tendon significantly increased the risk of tendinosis and partial tear. Conclusions: A high prevalence of structural changes in the rotator cuff and biceps tendons in masters swimmers reflects the effect of shoulder symptoms, aging, and swim training.


1999 ◽  
Vol 24 (3) ◽  
pp. 321-324 ◽  
Author(s):  
H. K. WATSON ◽  
J. WEINZWEIG

Ulnar wrist pain is a complex problem whose cause often remains elusive. A diagnostic triad of localized triquetral pain, history of a wrist hyperflexion injury, and normal radiographs, accompanied by ulnar wrist swelling and limited wrist motion, is often attributable to a syndrome we have termed triquetral impingement ligament tear (TILT). The mechanism of injury causes a cuff of fibrous tissue to be displaced distally from the ulnar sling mechanism, resulting in chronic impingement on the triquetrum that causes hyperaemia, loss of articular cartilage, and softening of the bone. Surgical repair consists of simply excising the impinging fibrous cuff. The outcome of 44 patients treated for TILT over a 6-year period is reviewed. In all cases, TILT repair resulted in improved wrist motion and strength. Ninety-five percent of patients reported a significant improvement in pain both at rest and with activity.


Author(s):  
Stephen McGhee ◽  
Juan M. Gonzalez ◽  
Johis Ortega
Keyword(s):  

2016 ◽  
Vol 25 (4) ◽  
pp. 309-314 ◽  
Author(s):  
John Manor ◽  
Elizabeth Hibberd ◽  
Meredith Petschauer ◽  
Joseph Myers

Context:Rounded-shoulder and forward-head posture can be contributing factors to shoulder pain. Corrective techniques such as manual therapy and exercise have been shown to improve these altered postures, but there is little evidence that corrective garments such as posture shirts can alter posture.Objectives:To determine the acute effects of corrective postureshirt use on rounded-shoulder and forward-head posture in asymptomatic college students.Design:Repeated-measures intervention study with counterbalanced conditions.Setting:Research laboratory.Participants:24 members of the general student body of a university, 18–25 y old, with a forward shoulder angle (FSA) >52° and no history of upper-extremity surgery, scoliosis, active shoulder pain, or shoulder pain in the previous 3 mo that restricted participation for 3 consecutive days.Interventions:Photographic posture assessment under a control condition, under a sham or treatment condition (counterbalanced), under another control condition, and treatment or sham.Main Outcome Measures:FSA and forward head angle (FHA) calculated from a lateral photograph.Results:FSA decreased relative to the control condition while participants wore the sham shirt (P = .029) but not the corrective posture shirt (P = 1.00). FHA was unchanged between groups (P = .371).Conclusions:Application of a corrective posture shirt did not acutely alter FSA or FHA, while application of a sham shirt may decrease FSA at rest.


2019 ◽  
pp. 1-2
Author(s):  
Ketan Khatri

INTRODUCTION:Intraosseous ganglion cyst of carpal bones is an uncommon cause of wrist pain. Although isolated cases of scaphoid and lunate have been reported in literature,intraosseous ganglion cyst in both scaphoid and lunate is rare. CASE REPORT:We report a case of 27 year old female who presented with a 6 month history of progressive left wrist pain. History of trauma was not reported. Conservative treatment with medications was unsuccessful. Examination revealed moderate swelling and tenderness over volar aspect of wrist with terminally painful wrist motions. Plain radiograph and MRI revealed well defined lesion in both scaphoid and lunate bone. Curettage and filling with radial bone graft provided a good functional recovery. CONCLUSION:we propose that early diagnosis of intraosseous ganglion is based on clinical presentation, proper radiologic investigation and index of suspicion can be helpful in the surgical management of intra osseous ganglion cyst in small bones of hand and intraosseous ganglion cyst may be considered as a differential diagnosis for wrist pain


Author(s):  
Kathleen Joy Khu ◽  
Rajiv Midha

A 22-year-old man presented with a one year history of rightsided shoulder pain, hand weakness and tingling, and purplish discoloration of the upper extremity upon abduction. He had congenital pseudarthrosis of the right clavicle since childhood. Aside from an obvious deformity characterized by asymmetry of the shoulders and a palpable bony depression over the right clavicle, the patient had been previously asymptomatic. Physical examination revealed the musculoskeletal deformities as described, as well as prominent veins over his right shoulder, arm, and chest. With arm elevation, his right arm became dusky and his radial pulse diminished. Neurologically, the patient had no deficits except for mild weakness (Grade 4+/5) of the ulnarinnervated intrinsic muscles of the right hand. The clinical findings were consistent with a combined neurogenic and vascular form of thoracic outlet syndrome.


Author(s):  
Priyanka Bagdi ◽  
Niranjani S.

Endometriosis is an estrogen-dependent inflammatory disease that affects 8 to 10% of women at reproductive age, characterized by the presence of endometrial glands and stroma outside the uterine cavity. In our case we are presenting a case report of a reproductive age group woman with appendicular endometriosis, because of the presence of pelvic endometriosis combined with an enlarged appendix, the choice was appendectomy, with complete suppression of abdominal symptoms after the surgery, a fact also reported by other authors. We concluded that endometriosis of the appendix is rare and almost never diagnosed before the surgery, with the definitive diagnosis obtained through microscopic examination. However, it should always be taken into account for the diagnosis of chronic pelvic pain, especially in young women complaining of recurrent pain, history of infertility and pelvic endometriosis. 


Author(s):  
Merve Akdeniz Leblebicier ◽  
Fatıma Yaman ◽  
İsmail Saraçoğlu ◽  
Vural Kavuncu ◽  
Meltem İmal Kızılkaya

Objectives: The aim of this study was to investigate whether shoulder ultrasound (US) findings were associated with disease activity and pain level in rheumatoid arthritis (RA) patients. Patients and methods: Between April 2019 and November 2019, a total of 60 shoulders of 30 female patients with RA (mean age: 53.8±12.0 years; range, 30 to 65 years) were included. The patients were questioned about shoulder pain and their Disease Activity Score-28 (DAS28) was estimated. After clinical examination with shoulder impingement tests, both shoulders were evaluated by US. Results: Of 60 shoulders examined by shoulder US, the most common shoulder pathology was supraspinatus tendinopathy (n=33, 55%). The prevalence of subdeltoid bursitis on US was significantly higher in the group with moderate disease activity, compared to the group with low disease activity (p<0.05). There were no significant differences in the physical examination findings of patients with low and moderate disease activity. In terms of US findings, subscapularis tendinopathy, glenohumeral joint and acromioclavicular joint degeneration, and subacromial bursitis were more common in shoulders with a history of pain, compared to non-painful shoulders. Conclusion: Shoulder US may be useful for demonstrating shoulder involvement in patients with RA, independent of the presence of shoulder pain.


2016 ◽  
pp. 3-23
Author(s):  
Stefano Gumina ◽  
Daniele Passaretti ◽  
Vittorio Candela

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