scholarly journals How to Insert Acupuncture Needles into the Subacromial Space through LI15

2021 ◽  
Vol 38 (3) ◽  
pp. 242-244
Author(s):  
Kwang Ho Lee
Keyword(s):  
Rotator Cuff ◽  
Acupuncture Point ◽  
Supraspinatus Tendon ◽  
Subacromial Space ◽  
Rotator Cuff Disease ◽  
Front Edge ◽  
Upper Arm ◽  
Acupuncture Needle ◽  
X Ray ◽  
Stimulation Of

LI15 is an important acupuncture point to treat shoulder pain. There are 4 needling methods for LI15 in the textbook; 1 method requires the insertion of the needle horizontally between the acromion and the great tuberosity of the humerus with the arm lowered for supraspinatus tendonitis. This method is also applicable for all conditions of rotator cuff disease, but it has not previously been described in detail. Providing X-ray scans and describing needle direction and depth of insertion will provide evidence for needling with the arm down as an effective stimulation of the subacromial space. Firstly, for this technique, with the arm raised, a concave point is located between the front edge of the acromion and the humerus, and the lower upper arm. Secondly, the acupuncture needle is inserted slightly posteriorly towards the supraspinous fossa, in the direction of the supraspinatus tendon and to a depth of 30-40 mm.

scholarly journals Features of Partial Rotator Cuff Tears Diagnostics

2019 ◽  
Vol 25 (2) ◽  
pp. 143-149 ◽  
Author(s):  
A. N. Logvinov ◽  
D. O. Ilyin ◽  
P. M. Kadantsev ◽  
O. V. Makarieva ◽  
M. E. Burtsev ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Shoulder Joint ◽  
Articular Surface ◽  
Supraspinatus Tendon ◽  
Rotator Cuff Tears ◽  
Joint Surface ◽  
Subacromial Space ◽  
Diagnostic Significance ◽  
Combined Application ◽  
Shoulder Range Of Motion

Partial rotator cuff tears are the most common pathology of the shoulder joint. Diagnostic of such conditions is a challenging problem for trauma surgeon.Purpose of the study is to analyze the diagnostic significance of manual tests and the standard MRI of the shoulder joint.Materials and Methods. The study is a retrospective analysis of disease history data of 25 patients (15 males, 10 females) treated at the authors’ hospital during the period from 2014 to 2017. Examination was performed according to a standard protocol: assessment of shoulder range of motion, palpation, manual examination, including “full/empty can” test, a painful arc symptom and the Hawkins – Kennedy test. All patients underwent MRI of the shoulder joint. The mean age of patients was 50.8 years. Shoulder joint arthroscopic inspection was considered the gold standard for diagnostics.Results. After data analysis, the following results were obtained: sensitivity of the “full can” test was 68%, the accuracy was 68%; “empty can” test sensitivity and accuracy were 76%, respectively. MRI sensitivity for diagnostics of supraspinatus tendon ruptures was 84% with the accuracy of 84%. The combination of the Hawkins – Kennedy test with the symptom of painful arch demonstrated accuracy and sensitivity of 64%. The study evaluated the effectiveness of MRI for diagnostic of the rupture type: sensitivity for injury from the joint surface — 80%, from the subacromial space — 70%; specificity for ruptures from the articular surface — 90% and from the subacromial space — 93%. The accuracy was 84% for both types of ruptures.Conclusions. Combined application of manual tests and MRI of the shoulder joint allows to diagnose partial rotator cuff tears in the majority of cases.

scholarly journals Gene Expression in Torn Rotator Cuff Tendons Determined by RNA Sequencing

2020 ◽  
Vol 8 (6) ◽  
pp. 232596712092748
Author(s):  
Robert Z. Tashjian ◽  
Ian Lock ◽  
Erin K. Granger ◽  
Yangliang Wang ◽  
Younghee Lee ◽  
...  
Keyword(s):  
Gene Expression ◽  
Endothelial Cell ◽  
Rotator Cuff ◽  
Target Genes ◽  
Secondary Analysis ◽  
Supraspinatus Tendon ◽  
Rotator Cuff Tears ◽  
Rotator Cuff Disease ◽  
Differential Gene ◽  
And Control

Background: Although the cause of rotator cuff tearing is likely multifactorial and a genetic predisposition has been proposed, the biochemical basis remains unknown. Purpose: To determine gene expression profiles in torn rotator cuff tendon tissue through use of RNA sequencing. Study Design: Controlled laboratory study. Methods: The supraspinatus tendon edge was biopsied in 24 patients undergoing arthroscopic rotator cuff repair for full-thickness supraspinatus rotator cuff tears. The supraspinatus tendon was also biopsied in 9 patients undergoing open reduction and internal fixation for a proximal humeral fracture (controls). Total RNA was extracted and sequenced. Differential gene expression was analyzed between the tear and control groups, and a secondary analysis was conducted between groups defined by an unbiased clustering. Results: Tear and control transcriptomes demonstrated significant differential expression in more than 3000 genes. The identified differential genes were highlighted in pathways involved in inflammation in control patients and extracellular matrix generation in patients with tears. Secondary analysis using unsupervised and thus unbiased hierarchical clustering revealed 2 clusters (c2 and c3). Cluster c3 contained smaller ( P < .001) and less retracted ( P = .018) tears (ie, tears earlier in the progression of rotator cuff disease) with increased expression of hypoxia target genes. Cluster c2 contained larger, more retracted tears (ie, tears further in the progression of rotator cuff disease) with increased expression of endothelial cell markers and chronic inflammation target genes. Tears in c2 had significantly worse healing rates compared with tears in c3 (0% vs 89%; P = .007). Conclusion: Smaller, less retracted tears had increased expression of hypoxia target genes and improved healing, whereas larger, more retracted tears were associated with endothelial cell markers and worse healing. Thus, hypoxia may be the inciting event for tear development, whereas with tear enlargement, a chronic, inflammatory, angiogenic process may predominate. Clinical Relevance: Identification of differential gene expression in rotator cuff tears may be a reliable tool to predict repair healing in the future.

Research appling arthroscopy in treatment of some shoulder’s diseases

2019 ◽  
pp. 61-67
Author(s):  
Dinh Khoa Nguyen ◽  
Van Hy Nguyen
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Shoulder Arthroscopy ◽  
Supraspinatus Tendon ◽  
Key Words Arthroscopy ◽  
Central Hospital ◽  
Rotator Cuff Disease ◽  
Tendon Tear ◽  
Cuff Tear ◽  
Difficult Procedure

Background: Shoulder athroscopy is a difficult procedure and have been appling in Hue Central Hospital in recent years. There was not any general research for this yet. Objective: To research symptoms and evaluate the result of shoulder arthroscopy. Subject and methods: Following research 38 patients who underwent shoulder arthroscopy in Hue Central Hospital from 6/2016 to 3/2019, assess after 6 months. Results: Instability shoulder was 61.5%, rotator cuff tear was 30.8% and impingement was 7.7%. Mean age was 43.8 and male was higher than female (p<0.05). Pain symtom is 100% in rotator cuff disease and 30.4% in instability, MRI found out injury 30.4 and 100% in instability and rotator cuff group, respectively. Anterior labral tear was 95.7% in instability group and supraspinatus tendon tear was 91.7% in rotator cuff tear group. Good and excelent result were 85% and 91.3% after 6 month in instability and rotator cuff group, respectively. Conclusion: Result of shoulder arthroscopy was good in Hue Central hospital. Key words: arthroscopy, instability, rotator cuff tear

scholarly journals The acromion–greater tuberosity impingement index: A new radiographic measurement and its association with rotator cuff pathology

2020 ◽  
Vol 28 (1) ◽  
pp. 230949902091334
Author(s):  
Hai-Xiao Liu ◽  
Xin Xian Xu ◽  
Dao Liang Xu ◽  
Yue Zheng Hu ◽  
Xiao-Yun Pan ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Good Predictor ◽  
Roc Curves ◽  
Supraspinatus Tendon ◽  
Rotator Cuff Tears ◽  
Subacromial Impingement Syndrome ◽  
Radiographic Measurement ◽  
Greater Tuberosity ◽  
X Ray ◽  
Trauma Group

Purpose: Several radiographic parameters describe humeral head coverage by the acromion. We describe a new radiographic measurement, the acromion–greater tuberosity impingement index (ATI), and its ability to predict rotator cuff pathology. Methods: The ATI was measured with magnetic resonance imaging (MRI) and X-ray analysis in 83 patients with rotator cuff pathology and 76 patients with acute rotator cuff tears. The lateral acromial angle (LAA), acromion type, the acromion index (AI) and the critical shoulder angle (CSA) were measured to assess their correlations with the ATI. Receiver operating characteristic (ROC) curves were used to predict degenerative rotator cuff pathology. The change in the ATI after acromion surgery was evaluated in both groups. Results: According to the ROC curves, the ATI is a good predictor of degenerative rotator cuff pathology on both X-ray (cut-off, 0.865) and MRI (cut-off, 0.965). Patients with degenerative rotator cuff pathology had a significantly higher average ATI compared to the trauma group ( p = 0.001 for X-ray and MRI). The degenerative group had a significantly lower LAA ( p = 0.001) and a higher ratio of type III acromion ( p = 0.035) than the trauma group. The ATI on X-ray was negatively related to the LAA and positively related to the AI, the CSA and acromion type (each p < 0.05). The ATI on MRI was negatively related to the LAA and positively related to the AI and acromion type (each p <0.05). More patients in the degenerative group than the trauma group needed acromioplasty or acromion decompression ( p < 0.05). The ATI on MRI was significantly lower after acromion surgery compared to before surgery in both groups ( p < 0.05). Conclusion: The ATI is a good predictor of degenerative supraspinatus tendon tears or subacromial impingement syndrome. The ATI on MRI is more accurate and can precisely guide acromion surgery.

MAGNETIC RESONANCE IMAGING CHARACTERISTICS AND ADDED VALUES OF X-RAY AND ULTRASONOGRAPHY IN DIAGNOSIS OF ROTATOR CUFF LESIONS

2020 ◽  
pp. 79-83
Author(s):  
Tuan Huynh Long ◽  
Thao Nguyen Thanh
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Rotator Cuff ◽  
Supraspinatus Tendon ◽  
Resonance Imaging ◽  
Tendon Tear ◽  
X Ray ◽  
Cuff Tear ◽  
Imaging Characteristics ◽  
Rotator Cuff Lesions

Purpose: To study magnetic resonance imaging characteristics and the added values of x-ray and ultrasonography in diagnosis of rotator cuff lesions. Material and method: 45 patients with clinical suspected rotator cuff lesions were recruited from may 2018 to august 2019 at Hue University of Medicine and Pharmacy Hospital. Patients undergone X-ray, Ultrasonography, and Mri of shoulder joint. The X ray and sonographic features were compared to MRI results to evaluate the added value of X-ray and ultrasonography in diagnosing rotator cuff lesions. Results: Ultrasound detected supraspinatus tear in 86.7%, tendonitiss in 40% and tenosynovitis in 8.9% of cases. X-ray detected suggestive features of supraspinatus tendon injuries in 88.9% of cases. Patients with two or more suggestive features was 46.7% with greater tuberosity sclerosis and calcification at the attachment site of tendon were the most common findings. The relationship between diagnosis of supraspinatus tendon tear, tendonitis and tenosynovitis on ultrasound with the number of suggested features on X-rays was 0.02, 0.564, 0.89. Conclusion: X-ray have supportive value for ultrasound in diagnosis of supraspinatus tendon tear. Keywords: Rotator cuff tear, MRI and Ultrasonography rotator cuff tear, The value of Ultrasonography in Rotator cuff lesions.

Sleep Impairment

2009 ◽  
Vol 14 (3) ◽  
pp. 7-10
Author(s):  
Craig Uejo ◽  
Stephen Demeter
Keyword(s):  
Rotator Cuff ◽  
Distal Clavicle ◽  
Rotator Cuff Disease ◽  
Degenerative Arthritis ◽  
Sixth Edition ◽  
Cuff Tear ◽  
Shoulder Region ◽  
Illness Causation ◽  
Traumatic Rotator Cuff Tear ◽  
Distal Clavicle Resection

Abstract In the AMAGuides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, distal clavicle resection (resection arthroplasty of the acromioclavicular joint [ACJ]) results in ratable impairment, but only a single diagnosis within a region may be rated. Therefore, if another impairing condition is present in the shoulder region (eg, impingement syndrome or rotator cuff disease) only that resulting in the greatest causally related impairment is rated. In the setting of an occupational or other compensable injury or illness, causation of the impairment often is a key issue because, typically, only impairment that is causally related to the injury can be rated. For example, assume that a lifting injury at work caused a tear in a rotator cuff tendon that was already attenuated by repetitive impingement on inferiorly projecting spurs from longstanding degenerative arthritis of the ACJ. If surgery was performed for a traumatic rotator cuff tear and the distal clavicle also was resected due to preexisting ACJ arthritis, the latter surgery is not considered to be related to the injury. In other words, because the ACJ arthritis was neither caused nor worsened by the injury, this condition is not rated. The distal clavicular resection may have been warranted to diminish pain due to ACJ arthritis and/or eliminate the distal clavicle as a source of impingement.

Magnetic Resonance Imaging of Pseudo-impingement of Rotator Cuff with Strength Training

2019 ◽  
Vol 1 ◽  
pp. 2-6
Author(s):  
Asad Naqvi ◽  
Timothy Ariyanayagam ◽  
Mir Akber Ali ◽  
Akhila Rachakonda ◽  
Hema N. Choudur
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Rotator Cuff ◽  
Strength Training ◽  
Radiology Department ◽  
Resonance Imaging ◽  
Subacromial Space ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Training Exercises

Objective: The objective of this study was to outline a novel unique concept of secondary impingement of the muscles, myotendons, and tendons of the rotator cuff from hypertrophy as a result of strength training exercises. Methods: In this retrospective observational study, 58 patients were referred for an magnetic resonance imaging (MRI) by the orthopedic surgeon to the radiology department over a period of 1½ years. All patients gave a history of strength training exercises and presented with clinical features of rotator cuff impingement. Results: We identified features of hypertrophy of rotator cuff muscles, myotendons, and tendons in 12 of these 58 patients. This was the only abnormality on MRI. The hypertrophy of rotator cuff muscles and tendon bulk completely filling the subacromial space to the point of overfilling and resulting in secondary compressive features. Conclusion: Rotator cuff impingement is a common phenomenon that can occur with various inlet and outlet pathological conditions. However, rotator cuff impingement may also result from muscle and tendon hypertrophy from strength training regimens. Hypertrophy of the rotator cuff can result in overfilling of the subacromial space, leading to secondary impingement, which we have termed as “pseudo-impingement.”

scholarly journals The influence of the Kinesio Taping on selected ultrasonography measurements, and quality of life in patients with rotator cuff lesions

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Aneta Bac ◽  
Magdalena Wróbel ◽  
Katarzyna Ogrodzka-Ciechanowicz ◽  
Edyta Michalik ◽  
Anna Ścisłowska-Czarnecka
Keyword(s):  
Quality Of Life ◽  
Rotator Cuff ◽  
Statistical Significance ◽  
Control Group ◽  
Subacromial Space ◽  
Kinesio Taping ◽  
Significant Difference ◽  
Rotator Cuff Lesions ◽  
Significant Change

Abstract The assessment of the six-week influence of Kinesio Taping combined with a rehabilitation on selected ultrasonography measurements, the level of disability, and the quality of life in patients with rotator cuff lesions. 60 participants were randomly assigned into a taping group (KT combined with a six-week rehabilitating protocol) and a control group (only rehabilitation protocol). In all patients the following assessments were performed twice: USG, UEFI and NHP questionnaires. In the examination of the subacromial space and the subacromial bursa in the taping group, no statistical significance was observed. A statistically significant change in the thickness of the muscles was obtained only for the thickness of the infraspinatus in the taping group. A statistically significant change was obtained in the assessment of tendinopathy only for the supraspinatus muscle in both groups. Within both groups a statistically significant difference was observed in the average UEFI and NHP scores; however, the differences in the scores obtained between the groups were not statistically significant. The use of KT with a rehabilitation program did not yield statistically significantly better results in the improvement of selected shoulder region indicators, the function of the upper limb and the quality of life.

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